AUTHOR=Lamoth Frédéric 

TITLE=Aspergillus fumigatus-Related Species in Clinical Practice

JOURNAL=Frontiers in Microbiology

VOLUME=7

YEAR=2016

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2016.00683

DOI=10.3389/fmicb.2016.00683

ISSN=1664-302X

ABSTRACT=<p><italic>Aspergillus fumigatus</italic> is the main etiologic agent of invasive aspergillosis (IA). Other <italic>Aspergillus</italic> species belonging to the section <italic>Fumigati</italic> (<italic>A. fumigatus</italic> complex) may occasionally be the cause of IA. These strains are often misidentified, as they cannot be distinguished from <italic>A. fumigatus</italic> by conventional morphological analysis and sequencing methods. This lack of recognition may have important consequences as these <italic>A. fumigatus</italic>-related species often display some level of intrinsic resistance to azoles and other antifungal drugs. <italic>A. lentulus</italic>, <italic>A. udagawae, A. viridinutans</italic>, and <italic>A. thermomutatus</italic> (<italic>Neosartorya pseudofischeri</italic>) have been associated with refractory cases of IA. Microbiologists should be able to suspect the presence of these cryptic species behind a putative <italic>A. fumigatus</italic> isolate on the basis of some simple characteristics, such as defect in sporulation and/or unusual antifungal susceptibility profile. However, definitive species identification requires specific sequencing analyses of the beta-tubulin or calmodulin genes, which are not available in most laboratories. Multiplex PCR assays or matrix-assisted laser desorption ionization – time-of-flight mass spectrometry (MALDI-TOF MS) gave promising results for rapid and accurate distinction between <italic>A. fumigatus</italic> and other <italic>Aspergillus</italic> spp. of the section <italic>Fumigati</italic> in clinical practice. Improved diagnostic procedures and antifungal susceptibility testing may be helpful for the early detection and management of these particular IA cases.</p>