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Sensitization to A fumigatus in subjects with non‐cystic fibrosis bronchiectasis
Author(s) -
Sehgal Inderpaul Singh,
Dhooria Sahajal,
Prasad Kuruswamy Thurai,
Muthu Valliappan,
Aggarwal Ashutosh Nath,
Rawat Amit,
Pal Arnab,
Bal Amanjit,
Garg Mandeep,
Chakrabarti Arunaloke,
Agarwal Ritesh
Publication year - 2021
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.13229
Subject(s) - bronchiectasis , aspergillus fumigatus , allergic bronchopulmonary aspergillosis , sensitization , medicine , immunology , aspergillosis , aspergillus , sputum , immunoglobulin e , tuberculosis , lung , microbiology and biotechnology , pathology , biology , antibody
Background Patients with chronic lung diseases, including cystic fibrosis (CF), are frequently sensitized to Aspergillus fumigatus . Whether patients with non‐CF bronchiectasis develop sensitization to A fumigatus remains unknown. Objective To evaluate the prevalence of sensitization and chronic infection with A fumigatus in subjects with bronchiectasis. We also performed a multivariate logistic regression analysis to identify factors predicting sensitization and chronic A fumigatus infection. Methods Subjects with bronchiectasis were investigated with serum A fumigatus ‐specific IgE and IgG, and sputum cultures for bacteria, fungus and mycobacteria. We defined A fumigatus sensitization and chronic A fumigatus infection as serum A fumigatus ‐specific IgE and IgG > 0.35 kUA/L and >27 mgA/L, respectively. We excluded subjects with bronchiectasis secondary to allergic bronchopulmonary aspergillosis. Results We included 258 subjects (TB [ n = 155], idiopathic [ n = 66] and other causes [ n = 37]) with bronchiectasis. The prevalence of Aspergillus sensitization, chronic Aspergillus infection, and both sensitization and chronic infection was 29.5% (76/258), 76% (196/258) and 26% (68/258), respectively. In a multivariate logistic regression analysis, TB‐related bronchiectasis was an independent risk factor for Aspergillus sensitization. Chronic Aspergillus infection was predicted by the duration of symptoms and specific aetiologies (tuberculosis and idiopathic) of bronchiectasis. The growth of Aspergillus species was also frequent in the TB group compared with other causes (32% vs 2%; P < .001). Conclusions We found a significant occurrence of Aspergillus sensitization and chronic infection in non‐CF bronchiectasis, especially in TB bronchiectasis. In addition to Aspergillus sensitization, investigations for chronic Aspergillus infection should be routinely performed in non‐CF bronchiectasis, both at diagnosis and during follow‐up.