Molecular Identification of Aspergillus spp. in Patients with Clinical Symptoms of Tuberculosis

BACKGROUND: Pulmonary tuberculosis (TB) is a major global health issue, with Mycobacterium tuberculosis as its primary cause. However, secondary infections like those from Aspergillus spp. can mimic TB symptoms, complicating diagnosis and treatment. This study examines polymerase chain reaction (PCR) as a rapid, sensitive tool for detecting Aspergillus spp. in patients with TB-like clinical presentations. METHODS: This study analyzed 110 sputum samples from patients exhibiting pulmonary TB symptoms at Wahidin Sudirohusodo General Hospital and Hasanuddin University Hospital, Makassar, Indonesia. Samples were examined using PCR with Aspergillus spp., specific primers, ASAP1 and ASAP2. Culture examination was conducted for result confirmation. RESULTS: Out of 110 samples, PCR detected Aspergillus spp. in 25 (22.7%) samples, while culture identified only 8 (7.2%) samples as positive. Among the PCR-positive samples, eight were also culture-positive, and 17 were culture-negative. Patients primarily fell within the productive age group (18-50 years, 49.1%), with a slight male predominance (58.1%) and notable comorbidity presence (52.7%). CONCLUSION: PCR significantly improves the detection of Aspergillus spp. in TB patients compared to culture, facilitating timely and accurate diagnosis of fungal coinfections. Improved diagnostic accuracy may enhance clinical management and treatment outcomes for TB patients.