Cho Hyun Kyu, Moon Seong Mi, Kim Hyoung-Tae, Shin Beomsu
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
Int J Microbiol. 2024 Apr 30;2024:1329884. doi: 10.1155/2024/1329884. eCollection 2024.
Distinct bacterial strains may affect the prognosis of patients with chronic respiratory diseases. However, little is known about the clinical significance of respiratory bacteria in patients with chronic pulmonary aspergillosis (CPA), a progressive and debilitating disease caused by spp.
This study aimed to analyze data obtained from CPA patients and their sputum or bronchial washing samples and investigate the prevalence and composition of respiratory bacteria and clinical implications. . We retrospectively reviewed the data of patients diagnosed with CPA between March 2019 and February 2023 in a tertiary referral hospital. We assessed the clinical characteristics and overall and pneumonia-specific survival rates of patients with CPA based on the presence of bacteria. s. We included 142 patients with CPA. The most commonly identified bacteria were (22.5%), followed by (21.8%) and (4.2%). Patients with isolated bacteria had a higher prevalence of older age, female sex, diabetes, and a history of extrathoracic malignancy than those without isolated bacteria ( = 0.024, 0.013, 0.021, and 0.034, respectively). Furthermore, over a median follow-up of 11 (4-21) months, the pneumonia-specific mortality rate was 13.4% (19/142), which was higher in patients with isolated bacteria than in those without ( = 0.045, log-rank test). Particularly, patients with the presence of had a significantly higher mortality rate from pneumonia than those without the presence of (adjusted hazard ratio, 3.34; = 0.015). In conclusion, CPA patients with isolated bacteria, especially , showed higher mortality rates due to pneumonia. Performing tests to identify bacteria in the lower respiratory tract of patients with CPA may be helpful in predicting future prognosis. Further studies are required to validate these findings in diverse ethnic groups.
不同的细菌菌株可能会影响慢性呼吸道疾病患者的预后。然而，对于慢性肺曲霉病（CPA）患者呼吸道细菌的临床意义知之甚少，CPA是一种由曲霉菌种引起的进行性衰弱性疾病。
本研究旨在分析从CPA患者及其痰液或支气管冲洗样本中获得的数据，调查呼吸道细菌的流行情况、组成及其临床意义。我们回顾性分析了2019年3月至2023年2月在一家三级转诊医院诊断为CPA的患者的数据。我们根据细菌的存在情况评估了CPA患者的临床特征以及总体生存率和肺炎特异性生存率。我们纳入了142例CPA患者。最常鉴定出的细菌是[具体细菌名称1]（22.5%），其次是[具体细菌名称2]（21.8%）和[具体细菌名称3]（4.2%）。与未分离出细菌的患者相比，分离出细菌的患者年龄较大、女性、患有糖尿病和有胸外恶性肿瘤病史的患病率更高（分别为P = 0.024、0.013、0.021和0.034）。此外，在中位随访11（4 - 21）个月期间，肺炎特异性死亡率为13.4%（19/142），分离出细菌的患者的肺炎特异性死亡率高于未分离出细菌的患者（P = 0.045，对数秩检验）。特别是，存在[具体细菌名称4]的患者肺炎死亡率显著高于不存在[具体细菌名称4]的患者（调整后的风险比为3.34；P = 0.015）。总之，分离出细菌的CPA患者，尤其是[具体细菌名称4]感染的患者，因肺炎导致的死亡率更高。对CPA患者下呼吸道进行细菌鉴定检测可能有助于预测未来预后。需要进一步研究在不同种族群体中验证这些发现。
