Three-Month Mortality in Nonhaematological Patients with Chronic Pulmonary Aspergillosis: Differences between Subtypes.

IF 4.2 2区 生物学 Q2 MICROBIOLOGY Journal of Fungi Pub Date : 2024-10-10 DOI:10.3390/jof10100706
Pablo González García, Julia Fernández-Navarro, Mónica Bru-Arca, Elisa Álvarez-Artero, Pablo Solís, María Pía Roiz Mesones, Juan Luis Muñoz Bellido, María Antonia García Castro, Moncef Belhassen-García, Javier Pardo Lledías
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Abstract

Objectives: Chronic pulmonary aspergillosis (CPA) is a fungal lung infection characterised by the slowly progressing destruction of the lung parenchyma and has four main subtypes. The objective of this work was to evaluate the epidemiology of CPA in our area and evaluate the involvement of the different subtypes in mortality. Methods: This was a descriptive longitudinal retrospective study developed in three tertiary hospitals in Spain. Among all patients admitted with a pulmonary aspergillosis diagnosis, we selected those who fulfilled the criteria for chronic aspergillosis according to the criteria of Denning, excluding those with a haematological disorder. Results: Among 409 inpatients recorded as having a pulmonary aspergillosis infection, only 76 (18.5%) fulfilled the criteria for CPA, with an estimated incidence of 0.67 cases/100,000 inhabitants/year. The subtypes detected were subacute invasive aspergillosis (SAIA) in 33 (43.4%) patients, simple aspergilloma (SA) in 25 (32.9%) patients, cavitary chronic aspergillosis (CCPA) in 13 (17.1%) patients, and chronic fibrosis (CFPA) in five (6.5%) patients. The overall three-month mortality rate was 23%, which was higher in SAIA patients. The predictors of early mortality were age > 65 years (OR 3.0 CI 95 1.0-9.5 p = 0.043) and the SAIA subtype vs. other subtypes (OR 3.1 CI 95 1.0-9.5 p = 0.042). Conclusions: The incidence rate estimated was inferior to that previously reported. The three-month mortality in patients with CPA was high, with older age and the SAIA subtype being the variable independent predictors of a worse prognosis.

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慢性肺曲霉菌病非血液病患者三个月的死亡率:亚型之间的差异。
目的:慢性肺曲霉菌病(CPA)是一种真菌性肺部感染,其特点是肺实质慢慢受到破坏,主要有四种亚型。这项工作的目的是评估本地区 CPA 的流行病学,并评估不同亚型对死亡率的影响。方法:这是一项在西班牙三家三级医院开展的描述性纵向回顾研究。在所有确诊为肺曲霉菌病的入院患者中,我们根据丹宁标准选择了符合慢性曲霉菌病标准的患者,并排除了患有血液病的患者。研究结果在 409 名有肺曲霉菌感染记录的住院患者中,只有 76 人(18.5%)符合 CPA 标准,估计发病率为 0.67 例/100,000 居民/年。发现的亚型分别为:33 例(43.4%)亚急性侵袭性曲霉菌病(SAIA)、25 例(32.9%)单纯曲霉瘤(SA)、13 例(17.1%)腔隙性慢性曲霉菌病(CCPA)和 5 例(6.5%)慢性纤维化曲霉菌病(CFPA)。三个月的总死亡率为 23%,其中 SAIA 患者的死亡率更高。预测早期死亡率的因素是年龄大于 65 岁(OR 3.0 CI 95 1.0-9.5 p = 0.043)和 SAIA 亚型与其他亚型(OR 3.1 CI 95 1.0-9.5 p = 0.042)。结论估计的发病率低于之前的报告。CPA患者三个月的死亡率较高,年龄较大和SAIA亚型是预后较差的可变独立预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Fungi
Journal of Fungi Medicine-Microbiology (medical)
CiteScore
6.70
自引率
14.90%
发文量
1151
审稿时长
11 weeks
期刊介绍: Journal of Fungi (ISSN 2309-608X) is an international, peer-reviewed scientific open access journal that provides an advanced forum for studies related to pathogenic fungi, fungal biology, and all other aspects of fungal research. The journal publishes reviews, regular research papers, and communications in quarterly issues. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on paper length. Full experimental details must be provided so that the results can be reproduced.
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