Chronic obstructive pulmonary disease (
COPD) patients have been recognized to be at increased risk of Aspergillus spp. colonization, which may progress to
invasive pulmonary aspergillosis (IPA). The objective of this study was to determine the frequency of Aspergillus colonization, or disease, in a cohort of
COPD patients. A prospective observational study was undertaken to determine Aspergillus colonization, or disease, in consecutive
COPD patients undergoing bronchoscopy. Fungal culture as well as
galactomannan antigen (GM) and Aspergillus
nucleic acid detection (PCR) were performed on bronchoalveolar lavage fluid (BAL) samples. One hundred and fifty patients were recruited. One hundred and twelve (74.7%) were outpatients, 38 (25.33%) were inpatients, of whom 6 (4%) were in the intensive care unit. Most patients (N = 122, 81.3%) were either
COPD GOLD (Global Initiative for
Chronic Obstructive Lung Disease) stages 1 or 2. Nine (6%) patients were on systemic
steroids, 64 (42.7%) on inhaled
steroids, and 9 (6%) on both. Seventeen patients (11.3%) had at least one positive test for Aspergillus detection (culture ± galactomannan ± polymerase chain reaction [PCR]), 13 (76.4%) of whom were
COPD GOLD stages 1 or 2. Five patients had probable or putative IPA. Aspergillus sp. was detected in five patients (3.3%) by culture, but detection increased to 17 (11.3%) by the additional testing for GM or Aspergillus
DNA. The frequency of Aspergillus detection in this cohort of
COPD patients may reflect the predominance of early
GOLD stages among the study population but deserves further investigation to determine its relevance as a predictive risk factor for IPA.
LAY SUMMARY:
COPD is a risk factor for Aspergillus spp. colonization. Bronchoalveolar lavage samples of 150
COPD patients were tested for presence of Aspergillus fumigatus, which was detected in five patients (3.3%) by culture, but detection of Aspergillus increased to 17 (11.3%) by additional GM and PCR testing.