OBJECTIVE: To explore clinical features of invasive pulmonary aspergillosis (IPA) vs. colonization among hospitalized COPD patients. METHODS: Records of COPD patients with two respiratory cultures yielding Aspergillus were retrospectively reviewed. Cases categorized as proven/probable IPA or colonization was analyzed. RESULTS: 118 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). CONCLUSIONS: IPA 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.
OBJECTIVE: To explore clinical features of invasive pulmonary aspergillosis (IPA) vs. colonization among hospitalized COPDpatients. METHODS: Records of COPDpatients with two respiratory cultures yielding Aspergillus were retrospectively reviewed. Cases categorized as proven/probable IPA or colonization was analyzed. RESULTS: 118 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-IIIpatients (54.2% vs. 0.0%, p < 0.001), but not in GOLD-IVpatients (69.2% vs. 31.3%, p = 0.066). CONCLUSIONS: IPA should be suspected not only in GOLD-III and GOLD-IVCOPDpatients, with higher mortality in IPA vs. colonized patients for GOLD-II and -III COPDpatients.
Authors: Pei Yee Tiew; Micheál Mac Aogáin; Soo Kai Ter; Stefano Aliberti; James D Chalmers; Sanjay H Chotirmall Journal: Mycopathologia Date: 2021-03-11 Impact factor: 2.574
Authors: Ana I Aller-García; Carmen Castro-Méndez; Ana Alastruey-Izquierdo; Elena M Marín-Martínez; Ismail Zakariya-Yousef Breval; Carmen Couto-Caro; Juan C López-Marín; Nicolás Peña-Griñán; Maite Ruiz de Pipaon; Ana M Romero-Mejías; Estrella Martín-Mazuelos Journal: Mycopathologia Date: 2016-12-02 Impact factor: 2.574
Authors: Kristen M Reeder; Joseph J Mackel; Matthew S Godwin; Chad W Dunaway; Jonathan P Blackburn; Rakesh P Patel; Chad Steele Journal: Infect Immun Date: 2018-09-21 Impact factor: 3.441
Authors: Lauren M Lilly; Michaella Scopel; Michael P Nelson; Ashley R Burg; Chad W Dunaway; Chad Steele Journal: Infect Immun Date: 2013-12-30 Impact factor: 3.441
Authors: Fabio Silvio Taccone; Anne-Marie Van den Abeele; Pierre Bulpa; Benoit Misset; Wouter Meersseman; Teresa Cardoso; José-Artur Paiva; Miguel Blasco-Navalpotro; Emmanuel De Laere; George Dimopoulos; Jordi Rello; Dirk Vogelaers; Stijn I Blot Journal: Crit Care Date: 2015-01-12 Impact factor: 9.097