Diagnostic significance of Aspergillus species isolated from respiratory samples in an adult pneumology ward
Diagnostic significance of Aspergillus species isolated from respiratory samples in an adult pneumology ward
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DOI：
10.3109/13693786.2010.548084
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发表时间：
2011-08-01
期刊：
影响因子：
2.9
通讯作者：
Kohno, Shigeru
中科院分区：
文献类型：
--
作者：
Tashiro, Takayoshi;Izumikawa, Koichi;Kohno, Shigeru
虽然在侵袭性肺曲霉病（IPA）免疫功能低下的宿主中，从呼吸道培养物中分离曲霉的诊断意义已经得到了研究，但在其他形式的曲霉病的免疫功能正常的患者中，对这种感染知之甚少。在这项成人肺炎病房患者的研究中，我们检查了曲霉菌与疾病患病率之间的关系。回顾了1998年4月至2009年3月的实验室记录，以确定呼吸道样本中含有曲霉菌的患者。评估分离种与患者临床特征之间的相关性。在研究期间，在139例患者的呼吸道培养中检测到165株曲霉。在这些患者中，62例（45%）被曲霉属定殖，没有表现出曲霉病的临床症状，而77例（55%）有一种肺曲霉病，其特征为慢性坏死性肺曲霉病（CNPA）（48%）、曲霉瘤（29%）、IPA（13%）或过敏性支气管肺曲霉病（ABPA）（10%）。优势种为烟曲霉（41%）、黑曲霉（32%）和花斑曲霉（12%）。烟曲霉最常见于IPA、曲霉菌瘤和CNPA患者，而黑曲霉是定植患者和ABPA患者的优势种。从呼吸道样本中分离出一种曲霉属并不能证实其为病原性病原体，因为曲霉属的气道定植是几种慢性肺部疾病的共同特征。反复分离相同种类的曲霉，检测血清中的抗曲霉抗体和/或曲霉抗原，以确定该分离物是否代表疾病的病原。
Although the diagnostic significance of isolating Aspergillus spp. from respiratory cultures has been studied in immunocompromised hosts with invasive pulmonary aspergillosis (IPA), little is known of such infections in immunocompetent patients with other forms of aspergillosis. In this study of adult pneumology ward patients, we examined the association between Aspergillus spp. and disease prevalence. Laboratory records from April 1998 to March 2009 were reviewed to identify patients with Aspergillus spp. in respiratory samples. Correlations between the isolated species and clinical characteristics of patients were evaluated. During the study period, 165 Aspergillus spp. isolates were detected in the respiratory cultures of 139 patients. Of these patients, 62 (45%) were colonized with Aspergillus spp. and displayed no clinical symptoms of aspergillosis, while 77 (55%) had a form of pulmonary aspergillosis, characterized as either chronic necrotizing pulmonary aspergillosis (CNPA) (48%), aspergilloma (29%), IPA (13%), or allergic bronchopulmonary aspergillosis (ABPA) (10%). The dominant species were Aspergillus fumigatus (41%), A. niger (32%), and A. versicolor (12%). A. fumigatus was most commonly isolated in patients with IPA, aspergilloma, and CNPA, whereas A. niger was the dominant species in colonized patients and those with ABPA. Isolation of an Aspergillus spp. from respiratory samples does not confirm it as the etiologic pathogen because airway colonization by Aspergillus spp. is a common feature in several chronic lung diseases. Repeated isolation of the identical Aspergillus species and detection of anti-Aspergillus antibodies and/or Aspergillus antigens in sera are needed to determine the isolate represents the etiologic agent of disease.