Dellière Sarah, Angebault Cécile, Fihman Vincent, Foulet Françoise, Lepeule Raphaël, Maitre Bernard, Schlemmer Frédéric, Botterel Françoise
Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France.
Dynamyc, UPEC, EnVA, ANSES, Créteil, France.
Front Microbiol. 2020 Jan 10;10:2980. doi: 10.3389/fmicb.2019.02980. eCollection 2019.
and are opportunistic pathogens that can cause severe pulmonary diseases. To date, the clinical significance of their concomitant isolation and potential interactions in the lung remains poorly understood. The aim of this study was to assess the prevalence of their concomitant isolation from respiratory samples, and to depict the related clinical and microbiological characteristics.
A retrospective monocentric study was conducted from January 2011 to December 2017, including all in-patients from whom positive cultures of and were obtained on respiratory samples within a 3-month period. Clinical, radiological and laboratory data were analyzed. Patients were categorized by a clinical and microbiological committee as "infected" or "colonized" by both pathogens according to current guidelines.
Overall, 140 patients had ≥1 respiratory samples positive for and concomitantly sent for fungal culture, and 708 were positive for , concomitantly sent for mycobacterial culture. Only 50 had at least one positive culture for both sp. and sp. Men represented 63% of patients, mean age was 61 years. A third of patients were immunocompromised and 92% had underlying lung diseases. was primarily found as a colonizing agent. Proportion of Complex ( = 0.02) was higher in patients co-carrying spp.
In this first study focusing on co-isolation of and in patient's respiratory samples, co-infection remains rare. Further studies are warranted in order to precise the exact relationship between these opportunistic pathogens and the clinical impact of co-isolations.
[具体病原体1]和[具体病原体2]是可导致严重肺部疾病的机会性病原体。迄今为止，它们在肺部同时被分离出的临床意义及其潜在相互作用仍知之甚少。本研究的目的是评估从呼吸道样本中同时分离出它们的患病率，并描述相关的临床和微生物学特征。
2011年1月至2017年12月进行了一项回顾性单中心研究，纳入所有在3个月内呼吸道样本[具体病原体1]和[具体病原体2]培养阳性的住院患者。对临床、放射学和实验室数据进行分析。根据现行指南，临床和微生物学委员会将患者分类为两种病原体均“感染”或“定植”。
总体而言，140例患者有≥1份呼吸道样本[具体病原体1]阳性并同时送检真菌培养，708例[具体病原体2]阳性并同时送检分枝杆菌培养。只有50例患者至少有一份[具体病原体1]和[具体病原体2]的阳性培养结果。男性占患者的63%，平均年龄为61岁。三分之一的患者免疫功能低下，92%有潜在肺部疾病。[具体病原体1]主要被发现为定植菌。同时携带[具体病原体2]菌种的患者中，[具体病原体1]复合体的比例更高（P = 0.02）。
在这项首次关注患者呼吸道样本中[具体病原体1]和[具体病原体2]共同分离的研究中，合并感染仍然罕见。有必要进行进一步研究以明确这些机会性病原体之间的确切关系以及共同分离的临床影响。
