کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3374671 | 1219641 | 2012 | 6 صفحه PDF | دانلود رایگان |
SummaryObjectiveTo explore clinical features of invasive pulmonary aspergillosis (IPA) vs. colonization among hospitalized COPD patients.MethodsRecords of COPD patients with two respiratory cultures yielding Aspergillus were retrospectively reviewed. Cases categorized as proven/probable IPA or colonization was analyzed.Results118 patients were identified: 70 (59.3%) colonized, 48 (40.7%) with IPA (42 probable, 6 proven). Higher percentage of IPA patients (vs. colonized) presented GOLD III + IV (77.1% vs. 57.1%, p = 0.025). IPA patients presented higher Charlson index (3.5 ± 2.5 vs. 2.6 ± 2.2, p = 0.027), higher rate of ICU admission (27.1% vs. 4.3%, p = 0.001) and worse prognosis (McCabe rapidly fatal category: 31.3% vs. 7.1%, p = 0.001). GOLD-I IPA patients presented risk factors other than COPD. Before hospitalization, 66.7% IPA and 28.6% colonized patients were taking steroids (p < 0.001). Antifungals were administered to 83.3% IPA and 21.4% colonized patients (p < 0.001). Mortality was higher among IPA vs. colonized patients, both in global (58.3% vs. 10.0%, p < 0.001), GOLD-I (75.0% vs. 10.0%, p = 0.041), GOLD-II (42.9% vs. 5.0%, p = 0.042) and GOLD-III patients (54.2% vs. 0.0%, p < 0.001), but not in GOLD-IV patients (69.2% vs. 31.3%, p = 0.066).ConclusionsIPA should be suspected not only in GOLD-III and GOLD-IV COPD patients, with higher mortality in IPA vs. colonized patients for GOLD-II and -III COPD patients.
Journal: Journal of Infection - Volume 65, Issue 5, November 2012, Pages 447–452