Clinical features of invasive pulmonary aspergillosis vs. colonization in COPD patients distributed by gold stage

Summary Objective To explore clinical features of invasive pulmonary aspergillosis (IPA) vs. colonization among hospitalized COPD patients. Methods Records of COPD patients with two respiratory cultures yielding Aspergillus were retrospectively reviewed. Cases categorized as proven/probable IPA or c...

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Bibliographic Details
Published in:The Journal of infection 2012-11, Vol.65 (5), p.447-452
Main Authors: Barberan, Jose, Sanz, Francisco, Hernandez, Jose-Luis, Merlos, Silvia, Malmierca, Eduardo, Garcia-Perez, Francisco-Javier, Sanchez-Haya, Eloy, Segarra, Mar, Garcia de la Llana, Francisco, Granizo, Juan-Jose, Gimenez, Maria-Jose, Aguilar, Lorenzo
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antifungal Agents - therapeutic use
Aspergillus niger - isolation & purification
Biological and medical sciences
Canada - epidemiology
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease, asthma
Female
General aspects
GOLD stage
Human mycoses
Humans
Indexing in process
Infectious Disease
Infectious diseases
Invasive pulmonary aspergillosis
Invasive Pulmonary Aspergillosis - drug therapy
Invasive Pulmonary Aspergillosis - epidemiology
Invasive Pulmonary Aspergillosis - immunology
Invasive Pulmonary Aspergillosis - microbiology
Male
Medical sciences
Middle Aged
Mycoses
Mycoses of the respiratory system
Pneumology
Pulmonary Disease, Chronic Obstructive - epidemiology
Pulmonary Disease, Chronic Obstructive - microbiology
Radiography, Thoracic
Retrospective Studies
Severity of Illness Index
United States - epidemiology
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Summary:Summary Objective To explore clinical features of invasive pulmonary aspergillosis (IPA) vs. colonization among hospitalized COPD patients. Methods Records of COPD patients with two respiratory cultures yielding Aspergillus were retrospectively reviewed. Cases categorized as proven/probable IPA or colonization was analyzed. Results 118 patients were identified: 70 (59.3%) colonized, 48 (40.7%) with IPA (42 probable, 6 proven). Higher percentage of IPA patients (vs. colonized) presented GOLD III + IV (77.1% vs. 57.1%, p  = 0.025). IPA patients presented higher Charlson index (3.5 ± 2.5 vs. 2.6 ± 2.2, p  = 0.027), higher rate of ICU admission (27.1% vs. 4.3%, p  = 0.001) and worse prognosis (McCabe rapidly fatal category: 31.3% vs. 7.1%, p  = 0.001). GOLD-I IPA patients presented risk factors other than COPD. Before hospitalization, 66.7% IPA and 28.6% colonized patients were taking steroids ( p  
ISSN:0163-4453
1532-2742
DOI:10.1016/j.jinf.2012.07.006