Chest
Original Research: Respiratory InfectionRisk Factors for PulmonaryAspergillus terreusInfection in Patients With Positive Culture for Filamentous Fungi
Section snippets
Study Population
A retrospective cohort study was performed involving 505 consecutive isolates of filamentous fungi in 332 patients who had been hospitalized or treated as outpatients in a single hospital between 1994 and 2004. The identified isolates were from the following respiratory samples: (1) sputum (considered valid when < 10 epithelial cells and > 25 polymorphonuclear cells were observed on a Gram stain); (2) BAL fluid; (3) bronchial aspirate; (4) fine-needle aspiration; and (5) lung biopsy specimen.
Description of Isolates and Population
A total of 505 cultures positive for filamentous fungi (Table 2), it was found that 127 of the 300 isolates ofA fumigatus(42.3%) corresponded to infection, without a statistical difference compared to episodes of colonization. However, 27 of the 46 isolates ofA terreus(58.7%) corresponded to invasive infection, and a significant difference was found compared to episodes of colonization (OR, 2.53; 95% CI, 1.37 to 4.69; p = 0.034).
Risk Factors for Positive Culture byA terreus
After the univariate analysis, multiple logistic regression
Discussion
In our study, 9.1% of the isolates of filamentous fungi observed over the 10-year period were due toA terreus. This fungus was the second most common cause of respiratory Aspergillus isolation, which contrasts with the findings reported in most previous studies.3, 10, 11In our series, the overall incidence of culture findings positive for filamentous fungi, includingA terreus, was 1.73 cases per 10,000 patients per year. This incidence was increased from 1998, coinciding with hospital
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2013, Infectious Disease Clinics of North AmericaCitation Excerpt :After transplant, A terreus infection can progress rapidly and is associated with a high mortality rate.108 A terreus tends to be resistant to AmB. Prophylactic use of aerosolized AmB, which is a common practice in lung transplant programs, is a risk factor for infection with this fungus.109–113 A terreus is generally susceptible to voriconazole and this is the drug of choice for invasive disease.
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This work was supported in part by Fondo Investigaciones Sanitarias de la Seguridad Social (grant No. G03/075 RESITRA).
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestjournal.org/misc/reprints.shtml).