Pulmonary Aspergillosis in Naïve Non-neutropenic Lung Cancer Patients

Abstract

to evaluate naïve lung cancer patients for the presence of aspergillosis. Pulmonary aspergillosis is the most common mould infection of the lungs. Patients with chronic lung disease or mild immunodeficiency are at risk. Lung cancer represents oncological challenge. Limited data are available about aspergillosis in newly diagnosed non neutropenic lung cancer patients. To identify fungal isolates and to determine the antifungal susceptibility. Inhibitory effect of secondary metabolites of fungal isolates on human fibroblast cell line was assessed. Cross section cohort study recruited newly diagnosed non neutropenic lung cancer patients. Bronchoalveolar lavage was obtained from 69 patients. Isolation of fungi on Sabouraud dextrose agar, morphological and molecular identification of fungal isolates, antifungal susceptibility testing and cell viability assay with cell culture and MTT assay were done. Aspergillus isolates were detected in 33 BAL samples out of the 69 patients (47.8%). The commonest isolate was A. niger. There was no significant correlation between total fungal count and age of patients. The antifungal Micafungin had a broad-spectrum and potent fungistatic activity against all fungal species with A. niger was the most sensitive. MTT assay was performed to evaluate the cytotoxic effect of both A. niger and A. fumigatus on normal lung cells (WI-38) and revealed that toxicity was concentration dependent and A. niger had significantly lower IC 50 which indicates more toxicity. In the context of diagnosis of lung cancer, vigilance should be kept to suspect and diagnose fungal infection as aspergillosis. Initiation of proper management can help improving patient outcome