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西班牙一家三级护理医院中新冠肺炎患者呼吸道样本曲霉菌属的分离情况

Isolation of Aspergillus spp. in respiratory samples of patients with COVID-19 in a Spanish Tertiary Care Hospital.

作者信息

Falces-Romero Iker, Ruiz-Bastián Mario, Díaz-Pollán Beatriz, Maseda Emilio, García-Rodríguez Julio

机构信息

Clinical Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain.

Infectious Diseases Unit, University Hospital La Paz, Madrid, Spain.

出版信息

Mycoses. 2020 Nov;63(11):1144-1148. doi: 10.1111/myc.13155. Epub 2020 Sep 4.

Abstract

BACKGROUND

Invasive pulmonary aspergillosis (IPA) is a complication of respiratory bacterial and viral infections such as coronavirus disease 2019 (COVID-19).

PATIENTS/METHODS: In University Hospital La Paz (Madrid, Spain), we reviewed the clinical and demographic characteristics of 10 patients with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR and Aspergillus spp. isolate in respiratory samples. We also recovered results of galactomannan tests in serum and/or bronchoalveolar lavage (BAL) samples.

RESULTS

Eight male and two female from 51 to 76 years were recovered. They had reported risk factors to develop IPA (haematological malignancies, immunosuppression, diabetes, obesity, intensive care unit stay, among others). Azole susceptible Aspergillus fumigatus was isolated in nine patients and Aspergillus nidulans was isolated in one patient. Only one case was classified as probable aspergillosis, seven cases as putative aspergillosis, and two cases were not classifiable. Eight patients received antifungal treatment. Seven patients died (70%), two are still inpatient due to nosocomial infections and one was discharged referred to another institution.

CONCLUSIONS

This clinical entity has high mortality, and therefore, it should be performed surveillance with early galactomannan tests and cultures in respiratory samples in order to improve the outcome of the patients with this condition.

摘要

背景

侵袭性肺曲霉病(IPA)是呼吸道细菌和病毒感染(如2019冠状病毒病(COVID-19))的一种并发症。

患者/方法:在西班牙马德里的拉巴斯大学医院,我们回顾了10例严重急性呼吸综合征冠状病毒2(SARS-CoV-2)PCR检测呈阳性且呼吸道样本中分离出曲霉属菌种的患者的临床和人口统计学特征。我们还获取了血清和/或支气管肺泡灌洗(BAL)样本中半乳甘露聚糖检测的结果。

结果

共纳入8名男性和2名女性,年龄在51至76岁之间。他们均有发生IPA的危险因素(血液系统恶性肿瘤、免疫抑制、糖尿病,肥胖、入住重症监护病房等)。9例患者分离出对唑类敏感的烟曲霉,1例患者分离出构巢曲霉。仅1例被分类为可能的曲霉病,7例为疑似曲霉病,2例无法分类。8例患者接受了抗真菌治疗。7例患者死亡(70%),2例因医院感染仍住院,1例出院后转诊至另一机构。

结论

这种临床病症死亡率高,因此,应通过早期半乳甘露聚糖检测和呼吸道样本培养进行监测,以改善患有这种病症患者的预后。

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