Prevalence and clinical impact of bacterial co-infection in chronaturenic pulmonary aspergillosis.

Abstract

Background: The clinical significance of co-infection with chronic pulmonary aspergillosis (CPA) and bacteria is limited and has mostly been studied in specific patient groups. This study aims to investigate the incidence and prognostic impact of bacterial co-infection in patients with CPA.

Methods: A single-center, retrospective, observational study was conducted between 2019 and 2024. Patients were categorized based on the presence of bacterial co-infection, and their demographics, potential underlying factors, and prognosis were analyzed.

Results: A total of 101 patients were included (mean age: 57 ± 13 years, 79 male). Bacterial co-infection was identified in 21 patients (21%). The most common bacterial pathogens at diagnosis were Pseudomonas aeruginosa (n = 6), Klebsiella pneumoniae (n = 5), Escherichia coli (n = 4), and Serratia marcescens (n = 4). Five patients had a history of prior bacterial colonization. At diagnosis, more than one bacterial species were identified in six patients. Sputum production and hypoxemic respiratory failure were more frequently observed in patients with bacterial co-infection. Systemic corticosteroid use was more common in the co-infected group. However, radiological findings and diagnostic procedures did not differ between the groups. Surgical interventions were more commonly performed in the non-co-infected group. During the follow-up, hospital admission rates, mortality, and overall survival were comparable between the two groups.

Conclusions: Bacterial co-infections are probable in CPA and follow-up results of both patient Groups may not differ. Timely diagnosis and close follow-up of these patients are probable key factors in these patients.