Distribution of Aspergillus species and risk factors for aspergillosis in mainland China: a systematic review.

IF 3.8 Q2 INFECTIOUS DISEASES Therapeutic Advances in Infectious Disease Pub Date : 2024-06-04 eCollection Date: 2024-01-01 DOI:10.1177/20499361241252537
Sabir Khan, Hazrat Bilal, Muhammad Shafiq, Dongxing Zhang, Muhammad Awais, Canhua Chen, Muhammad Nadeem Khan, Qian Wang, Lin Cai, Rehmat Islam, Yuebin Zeng
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Abstract

Background: Aspergillus, a widespread fungus in the natural environment, poses a significant threat to human health by entering the human body via the airways and causing a disease called aspergillosis. This study comprehensively analyzed data on aspergillosis in published articles from mainland China to investigate the prevalence of Aspergillus, and risk factors, mortality rate, and underlying condition associated with aspergillosis.

Methods: Published articles were retrieved from Google Scholar, PubMed, and Science Direct online search engines. In the 101 analyzed studies, 3558 Aspergillus isolates were meticulously collected and classified. GraphPad Prism 8 was used to statistically examine the epidemiology and clinical characteristics of aspergillosis.

Results: Aspergillus fumigatus was prominently reported (n = 2679, 75.14%), followed by A. flavus (n = 437, 12.25%), A. niger (n = 219, 6.14%), and A. terreus (n = 119, 3.33%). Of a total of 9810 patients, 7513 probable cases accounted for the highest number, followed by confirmed cases (n = 1956) and possible cases (n = 341). In patients, cough emerged as the most common complaint (n = 1819, 18.54%), followed by asthma (n = 1029, 10.48%) and fever (1024, 10.44%). Of total studies, invasive pulmonary aspergillosis (IPA) was reported in 47 (45.53%) studies, exhibiting an increased prevalence in Beijing (n = 12, 25.53%), Guangdong (n = 7, 14.89%), and Shanghai (n = 6, 12.76%). Chronic pulmonary aspergillosis (CPA) was reported in 14 (13.86%) studies. Among the total of 14 studies, the occurrence of CPA was 5 (35.71%) in Beijing and 3 (21.42%) in Shanghai. Allergic bronchopulmonary aspergillosis (ABPA), was reported at a lower frequency (n = 8, 7.92%), Guangdong recorded a relatively high number (n = 3, 37.5%), followed by Beijing (n = 2, 25.0%), and Shanghai (n = 1, 12.5%). Percentage of death reported: IPA had the highest rate (n = 447, 68.87%), followed by CPA (n = 181, 27.88%) and ABPA (n = 14, 2.15%). Among the aspergillosis patients, 6220 had underlying conditions, including chronic lung disease (n = 3765, 60.53%), previous tuberculosis (n = 416, 6.68%), and organ transplant or organ failure (n = 648, 10.41%). Aspergillosis was also found in patients using corticosteroid therapy (n = 622, 10.0%).

Conclusion: This review sheds light on the prevalence patterns of Aspergillus species, risk factors of aspergillosis, and gaps in surveillance that could be helpful for the control and treatment of aspergillosis and guide the researchers in future studies.

Registration: This systematic review was prospectively registered on PROSPERO: Registration ID CRD42023476870.

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中国大陆曲霉菌种的分布与曲霉菌病的风险因素:系统综述。
背景:曲霉菌是一种在自然环境中广泛存在的真菌,它通过呼吸道进入人体,引起曲霉菌病,对人类健康构成严重威胁。本研究全面分析了中国大陆发表的文章中有关曲霉菌病的数据,以调查曲霉菌病的发病率、风险因素、死亡率以及与曲霉菌病相关的基础疾病:方法:从 Google Scholar、PubMed 和 Science Direct 在线搜索引擎中检索已发表的文章。在分析的 101 项研究中,对 3558 株曲霉菌分离物进行了细致的收集和分类。使用 GraphPad Prism 8 统计曲霉菌病的流行病学和临床特征:结果:报告的曲霉菌主要是烟曲霉(n = 2679,75.14%),其次是黄曲霉(n = 437,12.25%)、黑曲霉(n = 219,6.14%)和赤曲霉(n = 119,3.33%)。在总共 9810 名患者中,7513 个可能病例最多,其次是确诊病例(n = 1956)和可能病例(n = 341)。在患者中,咳嗽是最常见的主诉(1819 人,占 18.54%),其次是哮喘(1029 人,占 10.48%)和发热(1024 人,占 10.44%)。在所有研究中,有 47 项(45.53%)研究报告了侵袭性肺曲霉菌病(IPA),北京(12 项,25.53%)、广东(7 项,14.89%)和上海(6 项,12.76%)的发病率较高。有 14 项(13.86%)研究报告了慢性肺曲霉菌病(CPA)。在总共 14 项研究中,北京和上海分别有 5 项(35.71%)和 3 项(21.42%)报告了慢性肺曲霉菌病。过敏性支气管肺曲霉菌病(ABPA)的报告频率较低(8 例,7.92%),广东的报告数量相对较多(3 例,37.5%),其次是北京(2 例,25.0%)和上海(1 例,12.5%)。报告的死亡比例:IPA的死亡率最高(447人,68.87%),其次是CPA(181人,27.88%)和ABPA(14人,2.15%)。在曲霉菌病患者中,有 6220 人患有基础疾病,包括慢性肺病(3765 人,60.53%)、既往结核病(416 人,6.68%)、器官移植或器官衰竭(648 人,10.41%)。使用皮质类固醇治疗的患者中也发现了曲霉菌病(n = 622,10.0%):本综述揭示了曲霉菌的流行模式、曲霉菌病的风险因素以及监测方面的不足,有助于控制和治疗曲霉菌病,并为研究人员今后的研究提供指导:本系统综述在 PROSPERO 上进行了前瞻性注册:注册编号为 CRD42023476870。
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CiteScore
5.30
自引率
8.80%
发文量
64
审稿时长
9 weeks
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