Clinical and Microbiological Characteristics of Proven Invasive Aspergillosis Due to Rare/Cryptic Species in Allogeneic Hematopoietic Stem Cell Transplant Recipients
Clinical and Microbiological Characteristics of Proven Invasive Aspergillosis Due to Rare/Cryptic Species in Allogeneic Hematopoietic Stem Cell Transplant Recipients
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已证实的同种异体造血干细胞移植受者中稀有/隐性物种引起的侵袭性曲霉病的临床和微生物学特征
DOI：
10.1128/aac.01630-21
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发表时间：
2022
影响因子：
4.9
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Yamamuro Ryosuke;Kimura Muneyoshi;Asano-Mori Yuki;Abe Masahiro;Nakamura Shigeki;Umeyama Takashi;et al.
关于异基因造血干细胞移植（allo-HSCT）受者中罕见/隐蔽菌种导致的侵袭性曲霉病（IA）的临床病程报道很少。我们回顾性审查了2012年1月至2018年12月期间接受allo-HSCT的患者的电子病历。在934例allo-HSCT受者中，10例被诊断为确诊IA，61例被诊断为可能IA。DNA测序证实IA的情况下进行，曲霉菌可以确定的物种水平在10例中的8个。三个是由于A。烟曲霉（A. fumigatus）和5株稀有/隐蔽曲霉（A. turcosus、A. felis，猫钩蛾A. viridinutans、绿壳拟步行虫A. nidulans和A. calidoustus。在这8例患者中，无A.烟曲霉死亡，而5例因稀有/隐蔽物种而患IA的患者中有3例在12周内死亡。2例存活的IA病例因罕见/隐匿种属而接受手术切除和抗真菌治疗。4例隐球菌药敏试验结果显示，3例隐球菌B MIC> 1 mg/L，2例伊曲康唑MIC> 1 mg/L，2例伏立康唑MIC> 1 mg/L。总之，超过一半的已证实的IA的致病病原体是罕见的/神秘的物种，因此，重要的是要准确地识别曲霉属物种。此外，考虑到致病微生物可能是耐唑型甲型流感病毒，手术治疗可能是确诊IA病例的重要选择。fumigatus或稀有/隐蔽物种。
There are few reports on the clinical course of proven invasive aspergillosis (IA) due to rare/cryptic species in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. We retrospectively reviewed the electronic medical records of patients who underwent allo-HSCT between January 2012 and December 2018. Of 934 allo-HSCT recipients, 10 were diagnosed with proven IA and 61 were diagnosed with probable IA. DNA sequencing was performed in cases of proven IA, and Aspergillus could be identified to the species level in 8 of the 10 cases. Three were due to A. fumigatus, and 5 were due to rare/cryptic Aspergillus species, namely,A. turcosus,A. felis, A. viridinutans, A. nidulans, and A. calidoustus. In these 8 patients, no patients with IA due to A. fumigatus died, whereas 3 of the 5 with IA due to rare/cryptic species died within 12 weeks. The 2 surviving cases of IA due to rare/cryptic species were treated with surgical resection and antifungal treatment. Susceptibility testing for cryptic species in 4 cases showed an amphotericin B MIC > 1 mg/L in 3 cases, itraconazole MIC > 1 mg/L in 2 cases, and voriconazole MIC > 1 mg/L in 2 cases. In conclusion, more than half of the causative pathogens of proven IA were rare/cryptic species, so it is important to accurately identify the Aspergillus species. In addition, surgical treatment might be an important option in cases of proven IA, given the possibility that the causative organisms are azole-resistant A. fumigatus or rare/cryptic species.
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预测中性粒细胞减少症患者侵袭性肺曲霉病肺切除术后的结果。
影响因子：
9.6
作者：
P. Matt;F. Bernet;J. Habicht;F. Gambazzi;A. Gratwohl;H. Zerkowski;M. Tamm
通讯作者：
M. Tamm
影响因子：
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作者：
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通讯作者：
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影响因子：
5.2
作者：
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通讯作者：
Pinheiro D
影响因子：
11.8
作者：
Kontoyiannis, Dimitrios P.;Marr, Kieren A.;Pappas, Peter G.
通讯作者：
Pappas, Peter G.
影响因子：
9.4
作者：
Pfaller, M. A.;Messer, S. A.;Diekema, D. J.
通讯作者：
Diekema, D. J.