Simoneau E, Kelly M, Labbe A C, Roy J, Laverdière M
Department of Microbiology-Infectious Diseases, Hôpital Maisonneuve-Rosemont, Quebec, Canada.
Bone Marrow Transplant. 2005 Feb;35(3):303-6. doi: 10.1038/sj.bmt.1704793.
Hematopoietic stem cell (HSC) transplantation is the most frequent underlying predisposing condition to invasive aspergillosis. However, the significance of positive blood culture with Aspergillus sp in this particular population remains uncertain. We retrospectively reviewed all blood cultures performed in 1453 patients who received HSC transplant at our institution between 1980 and 2002. We identified 19 patients with positive blood cultures with Aspergillus sp. Only one of these patients had clinical, histologic or microbiologic evidence of invasive aspergillosis. Thus, even in a population at highest risk for invasive aspergillosis, positive blood cultures with Aspergillus sp remain unusual, and cannot be readily associated with invasive aspergillosis. A case by case assessment by treating physicians of the clinical and radiologic parameters should be systematically made to establish the significance of aspergillemia. Single bottle positivity, obtained with the lysis-centrifugation blood culture system, is a common indicator of pseudoaspergillemia.
造血干细胞（HSC）移植是侵袭性曲霉病最常见的潜在易感因素。然而，在这一特定人群中，曲霉菌血培养阳性的意义仍不明确。我们回顾性分析了1980年至2002年间在我院接受HSC移植的1453例患者的所有血培养结果。我们确定了19例曲霉菌血培养阳性的患者。这些患者中只有1例有侵袭性曲霉病的临床、组织学或微生物学证据。因此，即使在侵袭性曲霉病风险最高的人群中，曲霉菌血培养阳性仍然不常见，且不能轻易与侵袭性曲霉病相关联。治疗医生应系统地对临床和放射学参数进行逐例评估，以确定曲霉血症的意义。采用裂解离心血培养系统获得的单瓶阳性是假曲霉血症的常见指标。
