Department of Respiratory Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
Department of Liver Infection, The Affiliated Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China.
Infection. 2022 Feb;50(1):169-178. doi: 10.1007/s15010-021-01679-6. Epub 2021 Aug 5.
Talaromyces marneffei (TM) is a pathogenic fungus endemic in Southeast Asia and human immunodeficiency virus (HIV)-positive populations, but studies related to non-endemic areas and HIV-negative populations are still limited. Therefore, this study aims to provide more additional evidence for clinical work of talaromycosis.
To collect clinical information of patients with talaromycosis admitted to hospitals in Zhejiang Province, China from January 1, 2010 to May 31, 2020, retrospectively analyzed clinical characteristics and prognosis, COX multivariate regression analysis was used for survival analysis.
A total of 92 patients were enrolled, including 76 males, 73 HIV-positive patients, with an average age of 40.1 ± 13.0. Compared to HIV-positive group, the negative group had higher admission age (47.7 ± 14.6 vs 38.1 ± 11.9, p = 0.003) and lower proportion of male (89.0% vs 57.9%, p = 0.004), there was no significant difference in imaging of lungs. There were significantly more HIV-positive patients in those with pleural effusion (100% vs 69.4%, p = 0.001). COX multivariate regression analysis suggested pleural effusion (HR = 3.220; 95% CI 1.117-9.287; p = 0.030) and HIV infection (HR = 0.057; 95% CI 0.009-0.370; p = 0.003) which were independent predictors of prognosis in patients with talaromycosis.
In non-endemic areas, clinical symptoms, signs, and laboratory tests of patients with talaromycosis are similar to those in endemic areas. Patients with pleural effusion have lower survival rate, HIV-infected people are less likely to relapse, and there is no significant correlation between extent of lung involvement and survival of infected patients.
马尔尼菲青霉（TM）是一种在东南亚和人类免疫缺陷病毒（HIV）阳性人群中流行的致病真菌，但有关非流行地区和 HIV 阴性人群的研究仍然有限。因此，本研究旨在为马尔尼菲青霉病的临床工作提供更多的证据。
收集 2010 年 1 月 1 日至 2020 年 5 月 31 日期间浙江省医院收治的马尔尼菲青霉病患者的临床资料，回顾性分析临床特征和预后，采用 COX 多因素回归分析进行生存分析。
共纳入 92 例患者，其中男性 76 例，HIV 阳性患者 73 例，平均年龄为 40.1±13.0。与 HIV 阳性组相比，HIV 阴性组的入院年龄更高（47.7±14.6 比 38.1±11.9，p=0.003），男性比例更低（89.0%比 57.9%，p=0.004），肺部影像学无明显差异。胸腔积液在 HIV 阳性患者中更为常见（100%比 69.4%，p=0.001）。COX 多因素回归分析表明，胸腔积液（HR=3.220；95%CI 1.117-9.287；p=0.030）和 HIV 感染（HR=0.057；95%CI 0.009-0.370；p=0.003）是马尔尼菲青霉病患者预后的独立预测因素。
在非流行地区，马尔尼菲青霉病患者的临床症状、体征和实验室检查与流行地区相似。胸腔积液患者的生存率较低，HIV 感染者不易复发，感染患者肺部受累程度与生存无明显相关性。
