Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes.
Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes.
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DOI：
10.1186/s13054-014-0722-7
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发表时间：
2015-01-12
期刊：
影响因子：
--
通讯作者：
AspICU Study Investigators
中科院分区：
文献类型：
--
作者：
Taccone FS;Van den Abeele AM;Bulpa P;Misset B;Meersseman W;Cardoso T;Paiva JA;Blasco-Navalpotro M;De Laere E;Dimopoulos G;Rello J;Vogelaers D;Blot SI;AspICU Study Investigators
侵袭性曲霉病（IA）是一种真菌感染，特别是影响免疫功能低下的主机。最近，一些研究表明，IA在重症监护病房（ICU）患者中的发病率很高。然而，在这种情况下，关于IA患者的流行病学和结局的数据很少。在8个国家的30个ICU中进行了一项观察性研究，包括ICU住院期间曲霉菌培养阳性的所有患者。根据最近验证的标准，将病例分类为已证实的IA、推定的IA或曲霉菌定植。收集人口统计学、微生物学和诊断数据。曲霉菌分离后12周记录结果。共纳入563例患者，其中266例定植（47%），203例推定IA（36%），94例证实IA（17%）。肺部是最常见的感染部位（94%），烟曲霉菌是最常见的分离菌种（92%）。IA患者的癌症和器官移植的发生率高于定植者。与其他患者相比，他们在ICU入院时更常被诊断为脓毒症，在ICU住院期间更常接受血管加压药和肾脏替代治疗（RRT）。定植患者的死亡率为38%，推定IA患者的死亡率为67%，确诊IA患者的死亡率为79%（P < 0.001）。IA患者死亡的独立风险因素包括年龄较大、骨髓移植史、机械通气、RRT和诊断时较高的序贯器官衰竭评估评分。重症患者中的IA与高死亡率相关。诊断为确诊或推定IA的患者比曲霉菌定植的患者病情更严重，更频繁地需要器官支持。
Invasive aspergillosis (IA) is a fungal infection that particularly affects immunocompromised hosts. Recently, several studies have indicated a high incidence of IA in intensive care unit (ICU) patients. However, few data are available on the epidemiology and outcome of patients with IA in this setting. An observational study including all patients with a positive Aspergillus culture during ICU stay was performed in 30 ICUs in 8 countries. Cases were classified as proven IA, putative IA or Aspergillus colonization according to recently validated criteria. Demographic, microbiologic and diagnostic data were collected. Outcome was recorded 12 weeks after Aspergillus isolation. A total of 563 patients were included, of whom 266 were colonized (47%), 203 had putative IA (36%) and 94 had proven IA (17%). The lung was the most frequent site of infection (94%), and Aspergillus fumigatus the most commonly isolated species (92%). Patients with IA had higher incidences of cancer and organ transplantation than those with colonization. Compared with other patients, they were more frequently diagnosed with sepsis on ICU admission and more frequently received vasopressors and renal replacement therapy (RRT) during the ICU stay. Mortality was 38% among colonized patients, 67% in those with putative IA and 79% in those with proven IA (P < 0.001). Independent risk factors for death among patients with IA included older age, history of bone marrow transplantation, and mechanical ventilation, RRT and higher Sequential Organ Failure Assessment score at diagnosis. IA among critically ill patients is associated with high mortality. Patients diagnosed with proven or putative IA had greater severity of illness and more frequently needed organ support than those with Aspergillus spp colonization.
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影响因子：
1.8
作者：
Dimopoulos, G;Piagnerelli, M;Vincent, JL
通讯作者：
Vincent, JL
影响因子：
11.8
作者：
Ascioglu, S;Rex, JH;Walsh, TJ
通讯作者：
Walsh, TJ
DOI：
10.1086/652768
发表时间：
2010-06-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Baddley JW;Andes DR;Marr KA;Kontoyiannis DP;Alexander BD;Kauffman CA;Oster RA;Anaissie EJ;Walsh TJ;Schuster MG;Wingard JR;Patterson TF;Ito JI;Williams OD;Chiller T;Pappas PG
通讯作者：
Pappas PG
影响因子：
4.9
作者：
Kim, Aryun;Nicolau, David P.;Kuti, Joseph L.
通讯作者：
Kuti, Joseph L.
影响因子：
38.9
作者：
Bulpa, PA;Dive, AM;Installé, EJ
通讯作者：
Installé, EJ