Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, China.
Xixi Hospital, Hangzhou, China.
J Infect Dis. 2020 Mar 16;221(Suppl 2):S193-S197. doi: 10.1093/infdis/jiz682.
Cases of severe influenza with Aspergillus infection are commonly reported in patients with severe influenza. However, the epidemiology, risk factors, and outcomes of invasive pulmonary aspergillosis (IPA) in patients with avian influenza A (H7N9) infection remain unclear. We performed a retrospective multicenter cohort study. Data were collected from patients with avian influenza A (H7N9) infection admitted to 17 hospitals across China from February 2013 through February 2018. We found that IPA was diagnosed in 18 (5.4%) of 335 patients; 61.1% of patients with IPA (11 of 18) were identified before or within 2 days after an H7N9 virus-negative result. The median hospital stays in patients with or without IPA were 23.5 and 18 days, respectively (P < .01), and the median intensive care unit stays, respectively, were 22 and 12 days (P < .01). Smoking in the past year and antibiotic use for >7 days before admission were independently associated with IPA (adjusted odds ratio [95% confidence interval], 6.2 [1.7-26] for smoking and 4.89 [1.0-89] for antibiotic use). These findings provided important insights into the epidemiology and outcomes of IPA in patients with H7N9 infection in China.
在患有严重流感的患者中，常报告有曲霉菌感染的严重流感病例。然而，人感染甲型禽流感（H7N9）患者中侵袭性肺曲霉病（IPA）的流行病学、危险因素和结局仍不清楚。我们进行了一项回顾性多中心队列研究。数据来自 2013 年 2 月至 2018 年 2 月期间在中国 17 家医院收治的甲型禽流感（H7N9）感染患者。我们发现，335 例患者中诊断出 18 例（5.4%）IPA；18 例 IPA 患者中有 61.1%（11 例）在 H7N9 病毒阴性结果之前或之后 2 天内确诊。有 IPA 和无 IPA 的患者的中位住院时间分别为 23.5 天和 18 天（P<.01），中位重症监护病房入住时间分别为 22 天和 12 天（P<.01）。既往吸烟和入院前抗生素使用超过 7 天与 IPA 独立相关（调整后的优势比[95%置信区间]，吸烟为 6.2[1.7-26]，抗生素使用为 4.89[1.0-89]）。这些发现为了解中国 H7N9 感染患者 IPA 的流行病学和结局提供了重要线索。
