• Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Valliappan Muthu, Ashutosh Nath Aggarwal, Amit Rawat, Arnab Pal, Amanjit Bal, Mandeep Garg, Arunaloke Chakrabarti, and Ritesh Agarwal.
• Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
• Mycoses. 2021 Apr 1; 64 (4): 412-419.

BackgroundPatients 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.ObjectiveTo 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.MethodsSubjects 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.ResultsWe 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).ConclusionsWe 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.© 2020 Wiley-VCH GmbH.

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