Microarray detection of fungal infection in pulmonary tuberculosis

• Main Authors: Nehad M. Osman, Ashraf A. Gomaa, Nehad M. Sayed, Ashraf A. Abd el aziz
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2013-01-01
• Series: Egyptian Journal of Chest Disease and Tuberculosis
• Subjects: Mycotic infection; Pulmonary tuberculosis; MDR-TB; DNA microarray
• Online Access: http://www.sciencedirect.com/science/article/pii/S0422763813000150

Background: Fungal pulmonary infection can be acquired in tuberculosis, immunodeficiency patients, and other chronic diseases. Many physicians missed fungal pulmonary infection because it does not show specific clinical manifestations. The aim was to identify the presence of overlapping fungal infections in tuberculosis patients, using high multiplexing capacity of DNA microarray. Methods: The present study was conducted on 50 tuberculosis patients who were subdivided into: Group I consisted of 30 cases of multidrug resistance tuberculosis, Group II consisted of 10 fresh cases and Group III consisted of 10 relapse cases. Morning sputum samples were examined by DNA microarray. Results: Aspergillus spp., was the only fungus detected in 24% of cases, Group I showed the highest percentage (26.6%) with statistically significant difference compared to Group II and III (20%) for each. Aspergillus fumigatus was the predominant spp. identified followed by Aspergillus niger and Aspergillus flavus. Mixed infection was identified in 4 cases in Group I. A statistical significant association between fungal detection and MDR-TB, diabetic patients, smoker, being male, presence of haemoptysis and toxic manifestations, presence of cavitary lesion or abscess and severity of X-ray finding. Conclusion: Microarray detection of mycotic infection represents a rapid diagnostic tool helping early diagnosis of fungal co-infection and pulmonary TB. MDR-TB patients carry the risk of higher percentage of fungal infections and more liable for acquiring mixed fungal pathogens. Presence of male sex, smoking, DM and far extent of lesion must attract physicians’ attention for fungal co-infection with pulmonary TB.