Epidemiology and outcome of infections due to Aspergillus terreus:: 10-year single centre experience
Epidemiology and outcome of infections due to Aspergillus terreus:: 10-year single centre experience
复制标题
DOI：
10.1111/j.1365-2141.2005.05763.x
复制
发表时间：
2005-10-01
影响因子：
6.5
通讯作者：
Nachbaur, D
中科院分区：
文献类型：
--
作者：
Lass-Flörl, C;Griff, K;Nachbaur, D
土曲霉，一种不太常见的病原体，似乎是一个新兴的感染原因，在我们的机构，因斯布鲁克医科大学医院。因此，流行病学和结果A。评估了过去10年的陆地感染情况。我们根据欧洲癌症/真菌病研究和治疗组织的标准，分析了67例确诊的侵袭性曲霉病（IA），调查了阿替霉素B（AMB）、伏立康唑和卡泊芬净的抗真菌药敏情况，并进行了A的分子分型。terreus已证实由A. terreus（n = 32）和non-A. terreus（n = 35）进行了评价。两组在年龄、性别、基础疾病、抗真菌治疗和中性粒细胞减少持续时间方面具有可比性（P > 0.05）。白血病是最常见的潜在恶性肿瘤。真菌传播发生在63%的患者。土曲霉菌感染患者对AMB治疗的应答率较低（20%），而非AMB患者的应答率为47%。地面感染（P < 0.05）。在离体条件下，A.发现terreus对AMB具有抗性，并且在患者分离株之间进行分子分型，显示出高菌株多样性，通过三种引物的组合鉴定出26种不同的类型（I-XXVI）。土曲霉菌感染在体外和体内均表现出AMB耐药的证据，并与高传播率和不良结局相关; terreus在奥地利蒂罗尔引起地方性的全身感染。A.土曲霉感染不取决于免疫抑制的程度，而是取决于环境曲霉属。exposure.
Aspergillus terreus, a less common pathogen, appears to be an emerging cause of infection at our institution, the Medical University Hospital of Innsbruck. Thus the epidemiology and outcome of A. terreus infections over the past 10 years was assessed. We analysed 67 cases of proven invasive aspergillosis (IA) according to the European Organisation for Research and Treatment of Cancer/Mycoses Study Group criteria, investigated antifungal susceptibility of amphotericin B (AMB), voriconazole and caspofungin and performed molecular typing of A. terreus. Patients with proven IA caused by A. terreus (n = 32) and non-A. terreus (n = 35) were evaluated. The two groups were comparable in terms of age, gender, underlying disease, antifungal prophylaxis and duration of neutropenia (P > 0.05). Leukaemia was the most common underlying malignancy. Fungal dissemination occurred in 63% of the patients. Aspergillus terreus infections were associated with a lower response rate to AMB therapy (20%), compared with 47% for patients with non-A. terreus infections (P < 0.05). In vitro, A. terreus was found to be resistant to AMB and molecular typing discriminated between patients isolates, showing a high strain diversity with 26 distinct types (I-XXVI) identified by combination of three primers. Aspergillus terreus infections displayed evidence of AMB resistance in vitro and in vivo and were associated with a high rate of dissemination and poor outcome; A. terreus causes systemic infections of endemic character in Tyrol, Austria. The onset of A. terreus infection depends not on the degree of immunosuppression but on environmental Aspergillus spp. exposure.