Wald A, Leisenring W, van Burik J A, Bowden R A
Department of Medicine, University of Washington, Seattle 98122, USA.
J Infect Dis. 1997 Jun;175(6):1459-66. doi: 10.1086/516480.
To investigate the incidence, risk factors, and outcome of Aspergillus infections among marrow transplant recipients, records from 2496 patients were reviewed, and 214 patients had Aspergillus organisms identified. Of these, 158 had invasive aspergillosis, 44 were colonized, and 12 had contaminated cultures. The incidence of invasive aspergillosis increased from 5.7% to 11.2% during the study. The onset of infection was bimodal, peaking 16 and 96 days after transplant. For patients within 40 days after transplant, underlying disease, donor type, season, and transplant outside of laminar air flow rooms were associated with significant risk for invasive aspergillosis. For patients >40 days after transplant, age, underlying disease, donor type, graft-versus-host disease, neutropenia, and corticosteroid use were associated with increased risk of aspergillosis. Only 31% of infected patients were neutropenic at the time of diagnosis. The risk factors for aspergillosis depend on the time after marrow transplant and include both host and environmental characteristics.
为了调查骨髓移植受者中曲霉菌感染的发生率、危险因素及转归，我们回顾了2496例患者的记录，其中214例患者鉴定出有曲霉菌。其中，158例患有侵袭性曲霉菌病，44例为定植，12例培养物被污染。在研究期间，侵袭性曲霉菌病的发生率从5.7%升至11.2%。感染的发生呈双峰模式，分别在移植后16天和96天达到高峰。对于移植后40天内的患者，基础疾病、供体类型、季节以及在层流空气室以外进行移植与侵袭性曲霉菌病的显著风险相关。对于移植后>40天的患者，年龄、基础疾病、供体类型、移植物抗宿主病、中性粒细胞减少症以及使用皮质类固醇与曲霉菌病风险增加相关。仅31%的感染患者在诊断时存在中性粒细胞减少。曲霉菌病的危险因素取决于骨髓移植后的时间，包括宿主和环境特征。
