Ahmed Jaweed, Singh Gagandeep, Mohan Anant, Agarwal Reshu, Sachdev Janya, Khullar Swati, Bhusan Xess Ashit, Mathur Purva, Das B K, Xess Immaculata
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, 110029, India.
Indian J Med Microbiol. 2022 Apr-Jun;40(2):223-227. doi: 10.1016/j.ijmmb.2022.02.006. Epub 2022 Mar 12.
This study was planned to determine the trends and susceptibility pattern of invasive pulmonary aspergillosis (IPA) in severely ill chronic obstructive pulmonary disease (COPD) patients admitted in pulmonary ward and ICU of our tertiary care centre.
Fifty COPD patients suspected of IPA from pulmonary ward and ICU from April 2017 to September 2018 were investigated. Samples were processed by standard methods, culture positive isolates were confirmed by MALDI-TOF MS and antifungal susceptibility testing was performed by microbroth dilution method.
Twenty-two critically ill COPD patients were microbiologically positive for IA infection, of which 13 were classified as putative invasive aspergillosis. The most common comorbid illness associated was diabetes. A. flavus and A. fumigatus were the commonest species isolated. The minimum inhibitory concentration of the antifungals was low. Morbidity due to IPA in COPD patients was very high.
Prevalence of IPA in the pulmonary ward and ICU was found to be 9.6%. MALDI-TOF seems to be a promising tool for aiding rapid identification especially for slow growing and non-sporulating fungi. Heightened awareness and suspicion for pulmonary mould infections along with early diagnosis can substantially alter the patient prognosis.
本研究旨在确定在我们三级医疗中心的肺病病房和重症监护病房（ICU）收治的重症慢性阻塞性肺疾病（COPD）患者中侵袭性肺曲霉病（IPA）的发病趋势和药敏模式。
对2017年4月至2018年9月期间肺病病房和ICU怀疑患有IPA的50例COPD患者进行调查。样本采用标准方法处理，培养阳性分离株通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）进行确认，抗真菌药敏试验采用微量肉汤稀释法进行。
22例重症COPD患者IA感染微生物学检测呈阳性，其中13例被归类为疑似侵袭性曲霉病。最常见的合并症是糖尿病。黄曲霉和烟曲霉是最常分离出的菌种。抗真菌药物的最低抑菌浓度较低。COPD患者中IPA导致的发病率非常高。
在肺病病房和ICU中，IPA的患病率为9.6%。MALDI-TOF似乎是一种很有前景的工具，有助于快速鉴定，特别是对于生长缓慢和不产孢的真菌。提高对肺部霉菌感染的认识和怀疑程度以及早期诊断可显著改变患者的预后。
