Characteristics of culture-positive invasive pulmonary aspergillosis in patients with hematologic diseases: Comparison between Aspergillus fumigatus and non-fumigatus Aspergillus species. Issue 49 (December 2017)

• Record Type: Journal Article
• Authors: Cho, Sung-Yeon; Lee, Dong-Gun; Choi, Jae-Ki; Lee, Hyo-Jin; Kim, Si-Hyun; Park, Sun Hee; Choi, Su-Mi; Choi, Jung-Hyun; Yoo, Jin-Hong; Park, Yeon-Joon; Lee, Jong-Wook
• Other Names: Hospenthal. Duane R. section editor.
• Is Part Of: Medicine. Volume 96:Issue 49(2017)
• Publication Date: 2017-12
• Subjects: Aspergillus fumigatus -- diagnosis -- hematology -- invasive pulmonary aspergillosis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000008841
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: While the epidemiology and clinical differences of various Candida spp. has been relatively well-identified, data regarding invasive aspergillosis (IA) caused by different Aspergillus spp. are insufficient. We aimed to determine the epidemiology of culture-positive invasive pulmonary aspergillosis (IPA) and to compare the characteristics and outcomes of Aspergillus fumigatus IPA with those of non- fumigatus IPA in patients with hematologic diseases. All consecutive cases of IPA from 2011 to 2015 were reviewed retrospectively. There were 430 proven/probable IPA and 76 culture-positive proven/probable IPA. Excluding cases of multiple species of fungi or cases having difficulties in species-level identification, 41 A fumigatus and 22 non- fumigatus IPA ( Aspergillus flavus [n = 11], Aspergillus niger [n = 6], and Aspergillus terreus [n = 5]) were compared. There were no significant differences in baseline characteristics between the 2 groups. However, disseminated IA was more common in non- fumigatus IPA (2.4% vs 18.2%; P = .046). Paranasal sinus (PNS) involvement was more common in non- fumigatus IPA. There was a trend towards higher peak serum galactomannan values in non- fumigatus IPA than in A fumigatus IPA group (median 1.33 [interquartile 0.98–3.29] vs 0.97 [0.66–1.97]; P = .084). Clinical response and mortality did not differ between groups. The culture-positive rate of proven/probable IPA was 17.7%, of which non- fumigatus Aspergillus accounted for about one-third. Disseminated IA, especially involving the PNS, was more frequent in non- fumigatus IPA than in A fumigatus IPA.