Text

Deteksi Antibodi IgM dan IgG Aspergillus dengan Metode Immunochromatography (ICT) pada Pasien Asma Persisten = Detection of Aspergillus IgM and IgG with Immunochromatography in Patients with Persistent Asthma.

Latar belakang: Pasien asma dapat mengalami sensitisasi terhadap Aspergillus sp. yang dapat menyebabkan aspergilosis bronkopulmoner alergika (ABPA). Kondisi ABPA, penggunaan steroid, dan kerusakan fungsi paru dapat meningkatkan risiko aspergilosis paru kronik (APK). Pemeriksaan baku emas mikologi APK adalah kultur jamur, yang memerlukan sumber daya terlatih dan waktu lama. Pemeriksaan imunokromatografi (ICT) Aspergillus dengan mekanisme lateral flow assay yang mudah dilakukan dan memerlukan sampel sedikit dapat menjadi alternatif baru deteksi Aspergillus sp. pada pasien asma persisten. Metode: Penelitian ini dilaksanakan pada Juni-November 2021, menyertakan 50 pasien asma persisten di RS Persahabatan yang direkrut pada penelitian sebelumnya. Bahan klinis terdiri atas 50 serum pasien untuk pemeriksaan ICT Aspergillus dan 15 sampel sputum untuk kultur jamur. Pemeriksaan dilakukan di laboratorium Departemen Parasitologi FKUI. Hasil: Demografi 50 subjek didominasi perempuan (78%) dan rerata usia subjek 55,8 tahun (SD±13,14). Hasil positif ICT Aspergillus ditemukan pada 16% (8 subjek). Pertumbuhan 17 isolat Aspergillus didapatkan pada sputum yang berasal dari 11 pasien, terdiri atas: Aspergillus niger (8 isolat), Aspergillus sp. (5 isolat), Aspergillus flavus (3 isolat), dan Aspergillus terreus (1 isolat). Tiga pasien memiliki hasil positif pada kultur dan ICT Aspergillus. Delapan dari pasien dengan hasil kultur positif memiliki hasil ICT negatif, meski 4 di antaranya memiliki 2 isolat Aspergillus. Kesimpulan: Pemeriksaan ICT Aspergillus menunjukkan hasil positif 16% pada 50 pasien asma yang diteliti. Kultur jamur pada sputum 11 dari 15 pasien menunjukkan pertumbuhan Aspergillus sebanyak 17 isolat, dengan spesies terbanyak A. niger. Tidak terdapat kaitan bermakna antara pemeriksaan ICT Aspergillus dengan hasil kultur jamur Aspergillus pada pasien asma persisten.
Kata kunci: asma, Aspergillus, imunokromatogafi, biakan


Introduction: Asthma patients can be sensitized to fungi, including Aspergillus sp. which can cause allergic bronchopulmonary aspergillosis (ABPA). The certain conditions such as ABPA, steroid consumption, and lung function disturbance can increase the risk of chronic pulmonary aspergillosis (CPA). The gold standard for mycology examination for CPA diagnosis is fungal culture, which is time-consumed and need special resources. Immunochromatography test (ICT) Aspergillus could be a new alternative for CPA diagnosis, including for asthma patients. Method: There were 50 persistent asthma patients from Persahabatan General Hospital who were recruited in previous study. Fifty sera were tested for ICT Aspergillus and 15 sputum samples for fungal culture. Result: Demography of 50 subjects was dominated by women (78%) and mean age was 55.8 years (SD±13.14). Positive ICT test result was 16%, and 17 Aspergillus isolated from sputum of 11 out of 15 patients, consisted of Aspergillus niger (8 isolates), diikuti Aspergillus sp. (5 isolates), Aspergillus flavus (3 isolates), and Aspergillus terreus (1 isolate). There were 3 patients with positive results in both ICT and Aspergillus culture. Eight patients with Aspergillus confirmation had negative ICT results, despite 4 out of 8 had 2 Aspergillus isolates. Conclusion: Aspergillus ICT in this study showed a positivity rate of 16%. There were 17 Aspergillus isolates from the sputum of 11 out of 15 patients, with A. niger as the most common species. There was no significant relationship between Aspergillus ICT examination and fungal culture results in persistent asthmatic patients.
Keywords: asthma, Aspergillus, immunochromatography, culture