Culture-positive invasive aspergillosis in a medical center in Taiwan, 2000-2009
Journal
European Journal of Clinical Microbiology and Infectious Diseases
Journal Volume
31
Journal Issue
7
Pages
1319-1326
Date Issued
2012
Author(s)
Abstract
We reviewed 776 patients who were culture positive for Aspergillus species at the hospital from 2000 to 2009. The isolates were collected for species identification by oligonucleotide hybridization and sequence analysis. A total of 96 cases of proven or probable IA were identified according to published criteria. The incidence of IA has increased significantly during the study period. Aspergillus fumigatus and A. flavus (41.7% each) were equally prevalent causative species. IA due to unusual species including A. nidulans (n=2), A. versicolor (n=2), and A. tubingensis (n=1) were also found. Among patients with IA, 55.2% had hematological disorder, 19.8% had underlying lung disorder, and 10.4% had autoimmune disease. The isolates species (P<0.001) and underlying disease (P<0.001) significantly affect the association of a positive culture with invasive disease. The overall mortality at three months was 62.5%, which remained stable throughout the study period. Multivariate analysis identified prior steroid use (P=0.007) as a significant risk factor for death, while surgery (P=0.030) and voriconazole (P= 0.012) had protective effects. In conclusion, autoimmune disorders and underlying pulmonary diseases should also be considered as important predisposing factors of IA. Further emphasis on surgery and voriconazole in the management of IA might be beneficial. ? Springer-Verlag 2011.
SDGs
Other Subjects
amphotericin B; amphotericin B lipid complex; caspofungin; echinocandin; fluconazole; itraconazole; steroid; voriconazole; antifungal agent; pyrimidine derivative; triazole derivative; voriconazole; adolescent; adult; aged; article; Aspergillus flavus; Aspergillus fumigatus; Aspergillus nidulans; Aspergillus tubigensis; aspergillus versicolor; autoimmune disease; child; decortication; disease association; disease predisposition; drug use; endoscopic surgery; female; finger amputation; fungus culture; fungus isolation; hematologic disease; hematopoietic stem cell transplantation; human; hybridization; incidence; infant; invasive aspergillosis; lung disease; lung lobectomy; major clinical study; male; malignant neoplastic disease; mortality; multivariate analysis; neutropenia; nose surgery; nucleotide sequence; oligonucleotide hybridization; oral surgery; pathogenesis; prediction; preschool child; priority journal; risk factor; school child; sequence analysis; species identification; Taiwan; treatment outcome; wedge resection; Aspergillus; classification; immunocompromised patient; isolation and purification; lung aspergillosis; microbiology; middle aged; survival; Taiwan; university hospital; Academic Medical Centers; Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Aspergillus; Child; Child, Preschool; Female; Humans; Immunocompromised Host; Incidence; Infant; Invasive Pulmonary Aspergillosis; Male; Middle Aged; Pyrimidines; Risk Factors; Survival Analysis; Taiwan; Triazoles; Young Adult
Type
journal article