Importance of Aspergillus spp. isolation in Acute exacerbations of severe COPD: prevalence, factors and follow-up: the FUNGI-COPD study.
Importance of Aspergillus spp. isolation in Acute exacerbations of severe COPD: prevalence, factors and follow-up: the FUNGI-COPD study.
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DOI：
10.1186/1465-9921-15-17
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发表时间：
2014-02-11
影响因子：
5.8
通讯作者：
Torres A
中科院分区：
文献类型：
--
作者：
Huerta A;Soler N;Esperatti M;Guerrero M;Menendez R;Gimeno A;Zalacaín R;Mir N;Aguado JM;Torres A
慢性阻塞性肺疾病急性加重期(AECOPD)通常与感染性因素有关，其中一些可能是不常见的，包括曲霉属。然而，曲霉菌的重要性。AECOPD的临床治疗仍不清楚。该研究的目的是分析与曲霉属有关的患病率和危险因素。分离AECOPD，并在一年的随访期内调查相关的临床结果。来自西班牙四家医院的AECOPD患者需要住院治疗。在入院时和随访期间(出院后1、6和12个月)收集临床、放射学和微生物学数据，并在随访期间收集再次入院和死亡数据。共有240名重症AECOPD患者纳入研究。144名患者(58%)获得了有效的痰样本，在这组患者中，曲霉菌的患病率。入院时隔离度为16.6%，随访一年时隔离度为14.1%。多因素Logistic回归分析显示，前一年AECOPD(OR12.35；95%CI，1.9~29.1；p<； 0.001)、同时分离病原菌(OR3.64；95%CI1.65~9.45，p = 0.001)和合并铜绿假单胞菌分离(OR2.8；95%IC1.81~11.42；p= 0.001)是曲霉菌感染的主要危险因素。与世隔绝。曲霉菌感染的主要危险因素。分离前一年的AECOPD和伴发的铜绿假单胞菌。然而，虽然曲霉属(Aspergillusspp.)通常在AECOPD患者的痰标本中分离到，其致病和临床意义尚不清楚。
Acute exacerbations of COPD (AECOPD) are often associated with infectious agents, some of which may be non-usual, including Aspergillus spp. However, the importance of Aspergillus spp. in the clinical management of AECOPD still remains unclear. The aims of the study were to analyze the prevalence and risk factors associated with Aspergillus spp. isolation in AECOPD, and to investigate the associated clinical outcomes during a 1-year follow-up period. Patients presenting with an AECOPD requiring hospitalization were prospectively included from four hospitals across Spain. Clinical, radiological and microbiological data were collected at admission and during the follow-up period (1, 6 and 12 months after discharge), and re-admissions and mortality data collected during the follow-up. A total of 240 patients with severe AECOPD were included. Valid sputum samples were obtained in 144 (58%) patients, and in this group, the prevalence of Aspergillus spp. isolation was 16.6% on admission and 14.1% at one-year follow-up. Multivariate logistic-regression showed that AECOPD in the previous year (OR 12.35; 95% CI, 1.9-29.1; p < 0.001), concurrent isolation of pathogenic bacteria (OR 3.64; 95% CI 1.65-9.45, p = 0.001) and concomitant isolation of Pseudomonas aeruginosa (OR 2.80; 95% IC, 1.81-11.42; p = 0.001) were the main risk factors for Aspergillus spp. isolation. The main risk factors for Aspergillus spp. isolation were AECOPD in the previous year and concomitant isolation of Pseudomonas aeruginosa. However, although Aspergillus spp. is often isolated in sputum samples from patients with AECOPD, the pathogenic and clinical significance remains unclear.
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影响因子：
--
作者：
Rosell, A;Monsó, E;Torres, A
通讯作者：
Torres, A
影响因子：
3.7
作者：
Guinea, Jesus;Padilla, Camilo;Bouza, Emilio
通讯作者：
Bouza, Emilio
DOI：
10.1111/j.1365-2222.2012.03987.x
发表时间：
2012-05
期刊：
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
影响因子：
--
作者：
Agbetile J;Fairs A;Desai D;Hargadon B;Bourne M;Mutalithas K;Edwards R;Morley JP;Monteiro WR;Kulkarni NS;Green RH;Pavord ID;Bradding P;Brightling CE;Wardlaw AJ;Pashley CH
通讯作者：
Pashley CH
影响因子：
38.9
作者：
Bulpa, PA;Dive, AM;Installé, EJ
通讯作者：
Installé, EJ
DOI：
10.1513/pats.200701-003fm
发表时间：
2007-10-01
期刊：
Proceedings of the American Thoracic Society
影响因子：
--
作者：
Anzueto, Antonio;Sethi, Sanjay;Martinez, Fernando J
通讯作者：
Martinez, Fernando J