Direct antiglobulin (Coombs) test in HIV-positive Talaromycosis marneffei patients.

IF 2.7 3区医学 Q3 INFECTIOUS DISEASES

Medical mycology Pub Date : 2024-08-02 DOI:10.1093/mmy/myae077

Mengyan Wang, Yujiao Jin, Biao Zhu

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Abstract

Talaromycosis marneffei (T.M) is the primary opportunistic infection of AIDS patients, and its morbidity and mortality are extremely high. To further clarify the disease characteristics of patients and provide a solid basis for in-depth exploration of their pathogenic mechanisms, we retrospectively summarized and analyzed their clinical data. We included all T.M patients tested for direct antiglobulin test (DAT) in the study. Interestingly, we found that AIDS-T.M patients had an extremely high rate of DAT positivity (92/127, 72.44%). In univariate analysis, a positive DAT was associated with blood culture of TM (P = .021), hypoproteinemia (P = .001), anemia (P = .001), thrombocytopenia (P = .003), sepsis (P = .007), and Sequential Organ Failure Assessment (SOFA) (P = .001). Hypoproteinemia, anemia, SOFA, APTT > 32.6 s, and AST > 40 U/l were studied by logistic regression. Logistic regression revealed that SOFA (OR = 1.311, P = .043), hypoproteinemia (OR = 0.308, P = .021), and anemia (OR = 0.19, P = .044) were associated with positive DAT. Positive DAT was associated with severe disease manifestations such as sepsis, and the DAT test is crucial in patients with fungemia.

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HIV 阳性 Talaromycosis marneffei 患者的直接抗球蛋白（库姆斯）试验。

马拉色菌病（Talaromycosis marneffei，T.M）是艾滋病患者的主要机会性感染，其发病率和死亡率极高。为了进一步明确患者的疾病特征，为深入探讨其致病机制提供坚实的基础，我们对患者的临床资料进行了回顾性总结和分析。我们将所有接受 DAT 检测的 T.M 患者都纳入了研究。有趣的是，我们发现艾滋病 T.M 患者的 DAT 阳性率极高（92/127，72.44%）。在单变量分析中，DAT 阳性与 TM 血培养（p = 0.021）、低蛋白血症（p = 0.001）、贫血（p = 0.001）、血小板减少（p = 0.003）、败血症（p = 0.007）和序贯器官衰竭评估（SOFA）（p = 0.001）相关。低蛋白血症、贫血、SOFA、APTT > 32.6S 和 AST > 40 U/L通过逻辑回归进行研究。逻辑回归显示，SOFA（OR = 1.311，P = 0.043）、低蛋白血症（OR = 0.308，P = 0.021）和贫血（OR = 0.19，P = 0.044）与 DAT 阳性相关。DAT 阳性与败血症等严重疾病表现有关，因此 DAT 试验对真菌血症患者至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical mycology 医学-兽医学

CiteScore

5.70

自引率

3.40%

发文量

632

审稿时长

12 months

期刊介绍： Medical Mycology is a peer-reviewed international journal that focuses on original and innovative basic and applied studies, as well as learned reviews on all aspects of medical, veterinary and environmental mycology as related to disease. The objective is to present the highest quality scientific reports from throughout the world on divergent topics. These topics include the phylogeny of fungal pathogens, epidemiology and public health mycology themes, new approaches in the diagnosis and treatment of mycoses including clinical trials and guidelines, pharmacology and antifungal susceptibilities, changes in taxonomy, description of new or unusual fungi associated with human or animal disease, immunology of fungal infections, vaccinology for prevention of fungal infections, pathogenesis and virulence, and the molecular biology of pathogenic fungi in vitro and in vivo, including genomics, transcriptomics, metabolomics, and proteomics. Case reports are no longer accepted. In addition, studies of natural products showing inhibitory activity against pathogenic fungi are not accepted without chemical characterization and identification of the compounds responsible for the inhibitory activity.