Kang Yuting, Li Qiujie, Ma Wanting, Xu Chao, Jia Wei, Wang Pengtao
Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
First Clinical Medical College, Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
Sci Rep. 2025 Apr 15;15(1):13036. doi: 10.1038/s41598-025-97587-y.
Invasive pulmonary aspergillosis (IPA) is a severe fungal infection primarily caused by Aspergillus fumigatus, representing a significant burden on public health. This study aims to address the limitations in the epidemiological characteristics, risk factors and diagnostic approaches for IPA by identifying clinical characteristics, laboratory findings, and chest CT imaging features that distinguish IPA from Aspergillus fumigatus colonization (AFC). We conducted a retrospective analysis of 249 hospitalized patients, including 77 with IPA and 172 with AFC, at Ningxia Medical University General Hospital from January 2018 to December 2023. Our findings revealed that patients with IPA exhibited higher rates of hemoptysis, dyspnea, and fever compared to those with AFC. Laboratory results indicated elevated levels of galactomannan (GM), white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and platelet count in IPA patients. Chest computed tomography imaging studies showed higher incidences of cavity, consolidation, ground-glass opacity, and halo sign in IPA patients. Voriconazole was the primary treatment for 75.3% of IPA patients, who also had longer hospital stays and higher treatment costs. Multivariate logistic regression identified GM, ESR, chronic obstructive pulmonary disease (COPD), and hypertension as significant risk factors for IPA. Our study highlights the necessity of developing enhanced diagnostic models that integrate GM and ESR biomarkers to improve the specificity and sensitivity of IPA diagnosis. These findings provide valuable insights for early diagnosis and optimized treatment strategies, potentially improving patient outcomes and reducing healthcare costs.
侵袭性肺曲霉病(IPA)是一种主要由烟曲霉引起的严重真菌感染,对公共卫生构成重大负担。本研究旨在通过识别区分IPA与烟曲霉定植(AFC)的临床特征、实验室检查结果和胸部CT影像学特征,解决IPA在流行病学特征、危险因素和诊断方法方面的局限性。我们对宁夏医科大学总医院2018年1月至2023年12月期间住院的249例患者进行了回顾性分析,其中包括77例IPA患者和172例AFC患者。我们的研究结果显示,与AFC患者相比,IPA患者咯血、呼吸困难和发热的发生率更高。实验室结果表明,IPA患者的半乳甘露聚糖(GM)、白细胞计数(WBC)、红细胞沉降率(ESR)和血小板计数水平升高。胸部计算机断层扫描成像研究显示,IPA患者空洞、实变、磨玻璃影和晕征的发生率更高。伏立康唑是75.3%的IPA患者的主要治疗药物,这些患者的住院时间更长,治疗费用更高。多因素逻辑回归分析确定GM、ESR、慢性阻塞性肺疾病(COPD)和高血压是IPA的重要危险因素。我们的研究强调了开发整合GM和ESR生物标志物的增强诊断模型以提高IPA诊断的特异性和敏感性的必要性。这些发现为早期诊断和优化治疗策略提供了有价值的见解,有可能改善患者预后并降低医疗成本。