New Delhi: Doctors at the All India Institute of Medical Sciences have confirmed the presence of resistant pathogens on drugs called Aspergillus Lentulus in two patients suffering from chronic obstructive pulmonary disease (COPD) treated at the hospital recently.
Both of them died during treatment.
Aspergillus Lentulus is a species of Aspergillus mushrooms known to cause infections in the lungs.
It was first described in medical literature in 2005.
Since then, several countries have been confirmed by infection in humans.
However, this is the first time that this aspergillus species has been reported to have infected patients in India, according to doctors.
According to a case report published at the Indian Journal of Medical Microbiology (IJMM), one of the patients was in the late 50s, the other in the early 40s.
Both have COPD.
The first person was referred to AIIMS from a private hospital when infection did not subside despite treatment, including administration of antibiotics and antifungal, in addition to additional oxygen therapy.
The IJMM report said the patient was given amphotericin B and voriconazole oral injections in AIIMS.
There was no improvement in clinical conditions for more than a month before he gave up on the fungal infection.
The second patient was rushed to AIIMS emergency with fever, cough and shortness of breath.
He was also given amphotericin B, but there was no improvement in the condition and he died after a week of multi-organ failure.
“For the best of our knowledge, this is the first report of India in the case of invasive lung aspergillosis in COPD patients caused by Aspergillus Lentulus,” said the IJMM report was written by Jaweed Ahmed, Gagandeep Singh, Immaculata Xess and Mragnayani Pandey from the Microbiology Department of AIIMS and Anant Mohan, Janya Sachdev, Prashant Mani and Bhaskar Rama from the Pulmonology Department existed.
There are more than one million species of mushrooms in the environment.
Dr.
Arunaloke Chakrabarti, who heads the WHO Collaborating Center for reference and fungi research from the importance of medical, told toi that up to a decade ago, 200-300 of them was known to cause disease.
“But now, there are more than 700 identified fungal species known to cause disease.
Some of them are resistant to available drugs, “he said.
Chakrabarti, who heads the medical microbiology department in PGI Chandigarh, said he has raised the issue of increasing fungal infections and the steps needed to prevent morbidity and mortality caused by 37 years, but it does not attract the attention of experts.
“Then the Covid-19 pandemic occurred and mucormycosis – another fungal infection – emerged as the main cause of death in severe covid patients.
What makes policy makers sit and think about the importance of creating infrastructure for the diagnosis and management of fungal infections, “said Chakrabarti.
Fungal infections are a group of diseases caused by fungi, organisms found free in the environment, according to Dr.
Chand Wattal, Chairperson, Clinical and Immunology Microbiology Institute, Ganga Hospital Sir Ram.
He added that most infections caused by treated mushrooms, infections for example, ringworm or nails.
“But there are infections caused by fungal species such as Candida, Aspergillus and Mascor which can cause systemic diseases to people with weak immunity and co-morbidity such as diabetes.
Infection can easily spread in the bloodstream and can nest in various parts of the body that are difficult to eradicate, “wattal added.
There are only three groups of antifungal drugs.
The infection caused by Candida Auris is treated by most of them, which is another challenge.
“Until about 15 years ago, only 30% of infections were caused by drug-resistant candida.
Now, almost 70% of this infection is resistant to drugs.
This caused serious problems in caring for patients, “said Dr.
Sumit Ray, the head of critical care at the Holy Family Hospital.
The high cost of antifungal drugs is another major obstacle in saving lives, he added.
With an increase in longevity and the incidence of accompanying diseases such as diabetes and chronic kidney disease, the doctor said the incidence of life-threatening fungal infections was possible to leave.
“One of the main reasons for the increase in fungal infections is the use of excessive antibiotics in India.
Kill good bad and good bacteria, thus creating favorable conditions for fungi growth known for disease causes, “explained the senior doctor.
Too often using steroids is a key factor.
“Steroids pressure the immune system, thereby reducing its ability to fight fungal infections.
In many cases Covid, we see how excessive use of steroids in treatment causes an epidemic of mucormycosis, “said the doctor.