González García Pablo, Fernández-Navarro Julia, Bru-Arca Mónica, Álvarez-Artero Elisa, Solís Pablo, Roiz Mesones María Pía, Muñoz Bellido Juan Luis, García Castro María Antonia, Belhassen-García Moncef, Pardo Lledías Javier
Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Universidad de Cantabria, 39008 Santander, Spain.
Complejo Asistencial de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, 37007 Salamanca, Spain.
J Fungi (Basel). 2024 Oct 10;10(10):706. doi: 10.3390/jof10100706.
: Chronic pulmonary aspergillosis (CPA) is a fungal lung infection characterised by the slowly progressing destruction of the lung parenchyma and has four main subtypes. The objective of this work was to evaluate the epidemiology of CPA in our area and evaluate the involvement of the different subtypes in mortality. : This was a descriptive longitudinal retrospective study developed in three tertiary hospitals in Spain. Among all patients admitted with a pulmonary aspergillosis diagnosis, we selected those who fulfilled the criteria for chronic aspergillosis according to the criteria of Denning, excluding those with a haematological disorder. : Among 409 inpatients recorded as having a pulmonary aspergillosis infection, only 76 (18.5%) fulfilled the criteria for CPA, with an estimated incidence of 0.67 cases/100,000 inhabitants/year. The subtypes detected were subacute invasive aspergillosis (SAIA) in 33 (43.4%) patients, simple aspergilloma (SA) in 25 (32.9%) patients, cavitary chronic aspergillosis (CCPA) in 13 (17.1%) patients, and chronic fibrosis (CFPA) in five (6.5%) patients. The overall three-month mortality rate was 23%, which was higher in SAIA patients. The predictors of early mortality were age > 65 years (OR 3.0 CI 95 1.0-9.5 = 0.043) and the SAIA subtype vs. other subtypes (OR 3.1 CI 95 1.0-9.5 = 0.042). : The incidence rate estimated was inferior to that previously reported. The three-month mortality in patients with CPA was high, with older age and the SAIA subtype being the variable independent predictors of a worse prognosis.
慢性肺曲霉病(CPA)是一种肺部真菌感染,其特征是肺实质缓慢进行性破坏,有四种主要亚型。本研究的目的是评估我们地区CPA的流行病学情况,并评估不同亚型在死亡率中的影响。
这是一项在西班牙三家三级医院开展的描述性纵向回顾性研究。在所有诊断为肺曲霉病的住院患者中,我们根据丹宁(Denning)标准选择了符合慢性曲霉病标准的患者,排除了患有血液系统疾病的患者。
在记录为患有肺曲霉病感染的409名住院患者中,只有76名(18.5%)符合CPA标准,估计发病率为0.67例/10万居民/年。检测到的亚型包括33名(43.4%)患者为亚急性侵袭性曲霉病(SAIA),25名(32.9%)患者为单纯曲霉球(SA),13名(17.1%)患者为空洞性慢性曲霉病(CCPA),5名(6.5%)患者为慢性纤维化(CFPA)。总体三个月死亡率为23%,SAIA患者的死亡率更高。早期死亡的预测因素为年龄>65岁(比值比3.0,95%置信区间1.0 - 9.5,P = 0.043)以及SAIA亚型与其他亚型相比(比值比3.1,95%置信区间1.0 - 9.5,P = 0.042)。
估计的发病率低于先前报道的发病率。CPA患者的三个月死亡率较高,年龄较大和SAIA亚型是预后较差的独立预测变量。