Aspergillosis in Critically Ill Patients with and Without COVID-19 in a Tertiary Hospital in Southern Brazil.

IF 3.6 3区 生物学 Q2 MYCOLOGY Mycopathologia Pub Date : 2024-06-07 DOI:10.1007/s11046-024-00862-1
Mariana Rodrigues Trápaga, Vanice Rodrigues Poester, Rossana Patrícia Basso, Bianca Dos Santos Blan, Lívia Silveira Munhoz, Alessandro C Pasqualotto, Talita da Fontoura Werner, Maria Letícia Figurelli, David A Stevens, Andrea von Groll, Melissa Orzechowski Xavier
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Abstract

The impact of invasive pulmonary aspergillosis (IPA) on non-neutropenic critically ill patients in intensive care units (ICU) has been demonstrated in recent decades. Furthermore, after the start of the COVID-19 pandemic, COVID-19 associated with pulmonary aspergillosis (CAPA) has become a major concern in ICUs. However, epidemiological data from different regions are scarce. We evaluated the prevalence and clinical-epidemiological data of IPA in patients with COVID-19 requiring mechanical ventilation (MV) in the ICU ("severe COVID-19") and non-COVID ICU patients in MV of a tertiary hospital in the southern region of Brazil. Eighty-seven patients admitted between June 2020 and August 2022 were included; 31 with severe COVID-19. For the diagnosis of IPA or CAPA, algorithms including host factors and mycological criteria (positive culture for Aspergillus spp., immunoassay for galactomannan detection, and/or qPCR) were utilized. The overall incidence of IPA and CAPA in our ICU was 73 cases/1000 ICU hospitalizations. Aspergillosis occurred in 13% (4/31) of the COVID-19 patients, and in 16% (9/56) of the critically ill patients without COVID-19, with mortality rates of 75% (3/4) and 67% (6/9), respectively. Our results highlight the need for physicians enrolled in ICU care to be aware of aspergillosis and for more access of the patients to sensitive and robust diagnostic tests by biomarkers detection.

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巴西南部一家三甲医院患有和未患有 COVID-19 的重症患者中的曲霉菌病。
近几十年来,侵袭性肺曲霉菌病(IPA)对重症监护病房(ICU)中非中性粒细胞减少的重症患者的影响已得到证实。此外,在 COVID-19 大流行开始后,COVID-19 相关肺曲霉菌病(CAPA)已成为重症监护病房的主要关注点。然而,来自不同地区的流行病学数据却很少。我们评估了巴西南部地区一家三甲医院需要在重症监护室进行机械通气(MV)的 COVID-19 患者("重症 COVID-19")和非 COVID ICU MV 患者中 IPA 的发病率和临床流行病学数据。研究纳入了2020年6月至2022年8月期间入院的87名患者,其中31人患有重度COVID-19。在诊断IPA或CAPA时,采用了包括宿主因素和真菌学标准(曲霉菌属培养阳性、半乳糖甘露聚糖免疫测定和/或qPCR)在内的算法。在我们的重症监护病房中,IPA和CAPA的总发病率为73例/1000例重症监护病房住院患者。COVID-19患者中有13%(4/31)发生了曲霉菌病,没有COVID-19的重症患者中有16%(9/56)发生了曲霉菌病,死亡率分别为75%(3/4)和67%(6/9)。我们的研究结果突出表明,参与重症监护室护理的医生需要了解曲霉菌病,并通过生物标记物检测为患者提供更多灵敏、可靠的诊断测试。
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来源期刊
Mycopathologia
Mycopathologia 生物-真菌学
CiteScore
6.80
自引率
3.60%
发文量
76
审稿时长
3 months
期刊介绍: Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.
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