Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), Universitat de Barcelona, Barcelona, Spain; REIPI (Spanish Network for Research in Infectious Diseases), Barcelona, Spain.
Clin Microbiol Infect. 2014 Nov;20(11):O939-45. doi: 10.1111/1469-0691.12650. Epub 2014 Jun 14.
Information on the environmental variables that may affect the incidence of invasive aspergillosis (IA) is scarce. We sought to determine the relationship between airborne spore counts, climatic conditions and IA. We also examined whether circulating respiratory viruses predispose patients to IA in a multicentre cohort study of hospitalized adults with IA. Data on environmental mould spores, climatic conditions and circulating respiratory viruses were obtained from the Environmental Department of the Autonomous University of Barcelona, the Meteorological Service of Catalonia and the Acute Respiratory Infection Surveillance Project in Catalonia, respectively. Between 2008 and 2011, 165 patients with IA were identified. Diagnosis was based on one or more of the following: culture (125 cases), galactomannan antigen (98) and histology (34). One hundred and twenty-seven cases (77%) had criteria for probable IA and the remainder for proven IA. Environmental mould spore counts from the period 28-42 days preceding infection presented significant associations with admissions due to IA. None of the climatic conditions were associated with an increased risk of IA, but the presence of circulating respiratory viruses was associated with a higher risk of infection: the most strongly associated viruses were respiratory syncytial virus, influenza A(H1N1)pdm09 and adenovirus. In conclusion, the presence of high numbers of spores in the air increases the risk of admission due to IA. Circulating respiratory viruses appear to be associated with a higher risk of developing IA. Physicians should be aware of this association in order to optimize prevention and diagnosis strategies for IA during viral epidemic periods.
有关可能影响侵袭性曲霉病 (IA) 发病率的环境变量的信息很少。我们旨在确定空气孢子计数、气候条件和 IA 之间的关系。我们还在一项针对住院成人 IA 的多中心队列研究中检查了循环呼吸道病毒是否使患者易患 IA。环境霉菌孢子、气候条件和循环呼吸道病毒的数据分别来自巴塞罗那自治大学环境部门、加泰罗尼亚气象局和加泰罗尼亚急性呼吸道感染监测项目。2008 年至 2011 年间，确定了 165 例 IA 患者。诊断依据是以下一项或多项：培养（125 例）、半乳甘露聚糖抗原（98 例）和组织学（34 例）。127 例（77%）符合可能 IA 的标准，其余为确诊 IA。感染前 28-42 天的环境霉菌孢子计数与因 IA 入院呈显著相关性。没有一种气候条件与 IA 风险增加相关，但循环呼吸道病毒的存在与感染风险增加相关：与病毒相关最强的是呼吸道合胞病毒、甲型流感 H1N1pdm09 和腺病毒。总之，空气中高浓度孢子的存在会增加因 IA 入院的风险。循环呼吸道病毒似乎与更高的 IA 发病风险相关。医生应该意识到这种关联，以便在病毒流行期间优化 IA 的预防和诊断策略。
