P386 Molecular identification and antifungal susceptibility of fungi causing sinusitis in arid climate region

Abstract Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Fungal sinusitis is a common problem worldwide with an increasing burden in arid climate regions. Clinical presentations of the disease range from allergic to acute invasive or chronic forms. In the present study, we aim to identify the etiology of fungal sinusitis in an arid climate region of Africa using molecular methods and to determine the antifungal susceptibility of the clinical isolates. Methods A total of 60 isolates collected from patients diagnosed with fungal sinusitis in Khartoum, Sudan were included. Direct microscopic examination and culture from nasal biopsies were performed at the mycology reference laboratory in Khartoum. To confirm the presence of fungal elements in tissue, histology was performed for all samples. Cultured isolates were then identified by sequencing the internal transcribed spacer (ITS), β-tubulin, and calmodulin gene regions. Antifungal susceptibility was tested using the protocol of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Results Sequencing of the three genes identified the following species: Aspergillus flavus (n = 48), A. citrinoterreus (n = 3), A. caespitosus (n = 2), A. sydowii (n = 2), Exserohilum sp. (n = 2), Purpureocillium lilacinum (n = 1), Trichosporon asahii (n = 1), and Fusarium chlamydosporum (n = 1). Conclusion The fungi associated with sinusitis are of high diversity; the 60 isolates were found to belong to 8 different species. With the exception of cryptic species, a large concordance was found between molecular and phenotypic identification methods. Aspergillus is the most commonly reported genus with A. flavus as the most prevalent species.