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Characteristics of Invasive Aspergillosis in Neutropenic Haematology Patients (Sousse, Tunisia)

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Abstract

Although scarce, available data suggest that the epidemiology of invasive aspergillosis (IA) in North Africa differs from northern countries, where more than 80 % is caused by Aspergillus fumigatus. This study aimed at describing the epidemiology of IA in the region of Sousse, Tunisia, and at assessing the usefulness of the available diagnostic tools. For 2 years, clinical and mycological data were prospectively collected from 175 neutropenia episodes of 91 patients hospitalised in the haematology department at the Farhat Hached hospital in Sousse (Tunisia). Screening for galactomannan antigen was positive in 40 % of neutropenia episodes; Aspergillus PCR was positive in 42 % of the tested sera. Nine patients were classified as probable and two as possible IA according to the EORTC/MSG criteria. Twelve patients who prematurely died, had no CT scan and could not be classified. Fifty-six Aspergillus spp. were isolated in 53 (6.5 %) sputa collected from 35 (20 %) patients. The following species were identified with MALDI-TOF mass spectrometry and DNA sequencing: A. niger, 35 %; A. flavus, 38 %; A. tubingensis, 19 %; A. fumigatus, 4 %; A. westerdijkiae, 2 % and A. ochraceus, 2 %. Our findings highlight the epidemiological features of IA in Tunisia, which is characterised by the predominance of Aspergillus spp. from sections Nigri and Flavi.

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Acknowledgments

This work was supported by the UR04SP24 Research Unit, from the Ministry of Health, Tunisia.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Service d’Hygiène Hospitalière, CHU Farhat Hached, Sousse, Tunisie

    Soukeina Gheith, Wadiaa Bannour & Mansour Njah

  2. Unité de recherche UR 04SP24, ministère de la Santé Publique, Tunis, Tunisie

    Soukeina Gheith, Fatma Saghrouni, Moncef Ben Said & Mansour Njah

  3. Laboratoire de Parasitologie-Mycologie, CHU Farhat Hached, Sousse, Tunisie

    Soukeina Gheith

  4. Service d’Hématologie clinique, CHU Farhat Hached, Sousse, Tunisie

    Yosra Ben Youssef & Abderrahim Khelif

  5. Parasitology and Mycology, CHU Timone-Adultes, Assistance Publique-Hôpitaux de Marseille, 13005, Marseille, France

    Anne-Cécile Normand, Renaud Piarroux & Stéphane Ranque

  6. Aix-Marseille Université, IP-TPT UMR MD3, 13885, Marseille, France

    Renaud Piarroux & Stéphane Ranque

  7. Laboratoire de Parasitologie-Mycologie, AP-HM Timone, 13385, Marseille Cedex 5, France

    Stéphane Ranque

Authors
  1. Soukeina Gheith
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  2. Fatma Saghrouni
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  3. Wadiaa Bannour
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  4. Yosra Ben Youssef
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  5. Abderrahim Khelif
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  6. Anne-Cécile Normand
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  7. Moncef Ben Said
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  8. Renaud Piarroux
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  9. Mansour Njah
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  10. Stéphane Ranque
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Correspondence to Stéphane Ranque.

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Gheith, S., Saghrouni, F., Bannour, W. et al. Characteristics of Invasive Aspergillosis in Neutropenic Haematology Patients (Sousse, Tunisia). Mycopathologia 177, 281–289 (2014). https://doi.org/10.1007/s11046-014-9742-8

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  • DOI: https://doi.org/10.1007/s11046-014-9742-8

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