Indian journal of medical microbiology · 2025
Prevalence and spectrum of fungal sensitization in bronchial asthma: Insights from Northern India.
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Deka Sangeeta, Sindhwani Girish, Kalita Deepjyoti, Gupta Pratima, Saikia Hiranya
Аннотация
PURPOSE: Fungal sensitization plays a crucial role in the development and severity of asthma. However, its prevalence and sensitization patterns vary significantly across different regions. This study aimed to determine the prevalence of fungal sensitization in asthmatic patients in this region and to identify the profile of the sensitizing fungi.
METHOD: This single-center cross-sectional study (February 2019-October 2022) at AIIMS Rishikesh investigated fungal sensitization in asthma patients. Skin prick tests (SPT) for nine fungal allergens (Aspergillus fumigatus, Alternaria alternata, Cladosporium herbarum, Fusarium moniliforme, Helminthosporium halodes, Penicillium chrysogenum, Rhyzopus nigricans, Serpula lacrymans, & Botrytis cinerea) and specific IgE by Immunoblot Assay (IBA) for eight fungi (Aspergillus spp, Alternaria alternata, Cladosporium herbarum, Penicillium chrysogenum, Rhyzopus nigricans, Mucor racemosus Candida albicans and Trichophyton mentagrophytes) were performed. Sputum samples were cultured on Sabouraud's Dextrose Agar, identified by MALDI-TOF. Statistical analysis, including ANOVA, Chi-square, and Kappa statistics, assessed correlations with age, sex, and concordance between SPT and IBA.
RESULTS: Overall 51 % of individuals were sensitized for one or more fungal antigen based on SPT and/or specific serum IgE results. Monosensitization was observed in 13.3 % patients while 37.6 were sensitized to multiple fungal species. Females were significantly more sensitized (p-value = 0.019). A. fumigatus showed maximum sensitization (37.6 %) followed by P. chrysogenum (23.1 %), Rhyzopus (21.8 %), Candida (23.1 %), Trichophyton (21.2 %), Helminthosporum (18.8 %) and Alternaria(15.8 %). Concordance between the two tests ranged from 48.1 % to 72.1 % for individual fungi, maximum being in A. fumigatus and minimum in C. herbarum. Kappa-agreement was moderate for A. fumigatus and A. alternata but was found to be statistically significant for all the five fungi.
CONCLUSION: This study highlights the high prevalence and diverse spectrum of fungal sensitization among asthma patients in northern India, emphasizing the need for region-specific diagnostic approaches and routine testing to improve early detection and tailored management strategies.
METHOD: This single-center cross-sectional study (February 2019-October 2022) at AIIMS Rishikesh investigated fungal sensitization in asthma patients. Skin prick tests (SPT) for nine fungal allergens (Aspergillus fumigatus, Alternaria alternata, Cladosporium herbarum, Fusarium moniliforme, Helminthosporium halodes, Penicillium chrysogenum, Rhyzopus nigricans, Serpula lacrymans, & Botrytis cinerea) and specific IgE by Immunoblot Assay (IBA) for eight fungi (Aspergillus spp, Alternaria alternata, Cladosporium herbarum, Penicillium chrysogenum, Rhyzopus nigricans, Mucor racemosus Candida albicans and Trichophyton mentagrophytes) were performed. Sputum samples were cultured on Sabouraud's Dextrose Agar, identified by MALDI-TOF. Statistical analysis, including ANOVA, Chi-square, and Kappa statistics, assessed correlations with age, sex, and concordance between SPT and IBA.
RESULTS: Overall 51 % of individuals were sensitized for one or more fungal antigen based on SPT and/or specific serum IgE results. Monosensitization was observed in 13.3 % patients while 37.6 were sensitized to multiple fungal species. Females were significantly more sensitized (p-value = 0.019). A. fumigatus showed maximum sensitization (37.6 %) followed by P. chrysogenum (23.1 %), Rhyzopus (21.8 %), Candida (23.1 %), Trichophyton (21.2 %), Helminthosporum (18.8 %) and Alternaria(15.8 %). Concordance between the two tests ranged from 48.1 % to 72.1 % for individual fungi, maximum being in A. fumigatus and minimum in C. herbarum. Kappa-agreement was moderate for A. fumigatus and A. alternata but was found to be statistically significant for all the five fungi.
CONCLUSION: This study highlights the high prevalence and diverse spectrum of fungal sensitization among asthma patients in northern India, emphasizing the need for region-specific diagnostic approaches and routine testing to improve early detection and tailored management strategies.