National Aspergillosis Centre Annual Report

The National Aspergillosis Centre produces a yearly report on its activities and achievements.

General Overview and highlights

This report covers the seventh full year of this nationally commissioned service. The number of new patients with chronic pulmonary aspergillosis (CPA) increased annually to 2012/13 and has now levelled off; 66 in 2009/10, 58 in 2010/11,74 in 2011/12 and 89 in 2012/13, 125 in 2013/14 and 119 in 2014/15, and 111 in 2015/16. Sixty seven patients died and 20 were discharged from service, leaving a total of 398 on service from England and Scotland and an additional 13 patients from Wales on April 1st 2016.This represents an 8.8% growth (9.4% growth in prior year). Non-CPA patients with aspergillosis are also being referred in larger numbers, a total of 346 in 2015/16.

The plan to utilise n-of-1 trials of posaconazole (and now isavuconazole) has been successful in that 34 of 78 patients trialled remained on the therapy and the remainder did not benefit and/or were intolerant. One application was made to NHSE for long term therapy but this was declined. Two patients that were on long term therapy have now come off and one remains on treatment.

The Mycology Reference Centre continues to process increasing numbers of samples,notably for aspergillus PCR (87% increase). Antifungal resistant rates in A. fumigatus remain above 10%. In March 2016, the 7th Advances Against Aspergillosis international meeting was held in Manchester, with 350 attendees. News of the meeting reached 8 million viewers via BBC Breakfast Time, BBC NW Tonight, BBC News, BBC local radio throughout the north west of England and ex-pat communities in Spain. Stories were also run in the Guardian, The Sun, The Mirror and Good Housekeeping magazine. A greater emphasis on reaching out to the public is bearing fruit in terms of general awareness.

UK guidelines on the investigation and diagnostic testing of patients with fungal diseases were published in Lancet Infectious Diseases. In January 2016, clinical guidelines for the diagnosis and management of CPA were published jointly by the European Society for Clinical Microbiology and Infectious Diseases and the European Respiratory Society. This is the first ever set of management guidelines for CPA.

The whole Manchester research group (fungi@manchester) published 57 papers and book chapters including some key observations including extremely high levels of the neutrophil chomattractant PPBP found in monocytes in CPA patients. In 2015,estimated country burdens of serious fungal diseases including chronic and allergic aspergillosis were published for 20 countries. A call for all populations to have access to fungal disease diagnostics and antifungal treatments was issued by the Global Action Fund for Fungal Infections in May 2015, an NGO closely linked to the National Aspergillosis Centre.

Download the Annual Report 2015/16