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Identification of Non-fumigatus Aspergillus Species in Clinical Samples from Southern California

Summary

Researchers studied fungal infections caused by Aspergillus in Southern California from 2012 to 2023, examining over 10,000 patients. They found that species other than the commonly known A. fumigatus were actually more prevalent in clinical samples, particularly A. niger from skin and nail infections. Importantly, these non-fumigatus species showed seasonal patterns and some carry resistance to standard antifungal medications, suggesting doctors may need to adjust their treatment approaches for fungal infections.

Background

Aspergillus is a causative agent of aspergillosis with presentations ranging from mild skin infections to disseminated disease. While A. fumigatus has historically been identified as the source of most serious infections, there is emerging concern for invasive disease caused by non-fumigatus species, especially those carrying intrinsic resistance to recommended antifungals.

Objective

To review trends in Aspergillus species cultured from a large clinical cohort in Southern California and describe the epidemiology and distribution patterns of non-fumigatus Aspergillus species.

Results

10,777 patients were identified with at least one positive Aspergillus culture. Aspergillus niger was the most frequently cultured species overall (44.6% from skin, nail, and scalp samples). A. fumigatus was identified in 40.3% of respiratory samples compared to A. niger at 25.7%. Non-fumigatus species exhibited seasonal trends in respiratory samples, peaking in early autumn.

Conclusion

Non-fumigatus Aspergillus species were identified more frequently than A. fumigatus in both respiratory and non-respiratory clinical samples. Seasonal trends and increasing predominance of non-fumigatus species may indicate a shift in clinical expectations and treatment options for aspergillosis management.
  • Published in:Open Forum Infectious Diseases,
  • Study Type:Descriptive Analysis,
  • Source: 10.1093/ofid/ofae631.2286, PMID: PMC11777753
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