2012-2018年法国黄曲霉侵袭性曲霉病的特点

IF 7.2 2区医学 Q1 IMMUNOLOGY

Emerging Infectious Diseases Pub Date : 2025-05-01 DOI:10.3201/eid3105.241392

Lise Bertin-Biasutto,Olivier Paccoud,Dea Garcia-Hermoso,Blandine Denis,Karine Boukris-Sitbon,Olivier Lortholary,Stéphane Bretagne,Maud Gits-Muselli,Raoul Herbrecht,Valérie Letscher-Bru,François Danion,Sophie Cassaing,Florent Morio,Céline Nourrisson,Marc Pihet,Milène Sasso,Guillaume Desoubeaux,Marie-Fleur Durieux,Julie Bonhomme,Elisabeth Chachaty,Taieb Chouaki,Nicole Desbois-Nogard,Alexandre Alanio,Jean-Pierre Gangneux,Fanny Lanternier

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引用次数: 0

摘要

由黄曲霉引起的侵袭性曲霉病（IA）的描述仍然很少。我们回顾性分析了2012-2018年法国报告的54例黄芽孢杆菌引起的IA病例。在这些病例中，潜在的IA危险因素是恶性肿瘤、实体器官移植和糖尿病。大多数感染（87%,47/54）为局部感染，其中胸膜肺感染33例，耳鼻喉部感染13例。恶性肿瘤（70%[23/33]）和实体器官移植（21%[7/33]）是局限性肺部感染的主要危险因素，糖尿病与局限性耳鼻喉受累相关（61.5%,[8/13]）。真菌合并感染常见于肺部（36%,12/33），但不见于耳鼻喉科（0例）。45/50（90%）的病例使用抗真菌单药治疗，主要是伏立康唑（67%,30/45）。全因30天病死率为39.2%，90天病死率为47.1%，病死率因危险因素、IA部位和真菌合并感染而异。临床医生应对黄芽孢杆菌保持警惕，并将其作为IA的鉴别诊断。

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Features of Invasive Aspergillosis Caused by Aspergillus flavus, France, 2012-2018.

Invasive aspergillosis (IA) caused by Aspergillus flavus remains poorly described. We retrospectively analyzed 54 cases of IA caused by A. flavus reported in France during 2012-2018. Among cases, underlying IA risk factors were malignancy, solid organ transplantation, and diabetes. Most (87%, 47/54) infections were localized, of which 33 were pleuropulmonary and 13 were ear-nose-throat (ENT) infection sites. Malignancy (70% [23/33]) and solid organ transplantation (21% [7/33]) were the main risk factors in localized pulmonary infections, and diabetes mellitus was associated with localized ENT involvement (61.5%, [8/13]). Fungal co-infections were frequent in pulmonary (36%, 12/33) but not ENT IA (0 cases). Antifungal monotherapy was prescribed in 45/50 (90%) cases, mainly voriconazole (67%, 30/45). All-cause 30-day case-fatality rates were 39.2% and 90-day rates were 47.1%, and rates varied according to risk factor, IA site, and fungal co-infections. Clinicians should remain vigilant for A. flavus and consider it in the differential diagnosis for IA.

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来源期刊

Emerging Infectious Diseases 医学-传染病学

CiteScore

17.30

自引率

1.70%

发文量

505

审稿时长

1 months

期刊介绍： Emerging Infectious Diseases is a monthly open access journal published by the Centers for Disease Control and Prevention. The primary goal of this peer-reviewed journal is to advance the global recognition of both new and reemerging infectious diseases, while also enhancing our understanding of the underlying factors that contribute to disease emergence, prevention, and elimination. Targeted towards professionals in the field of infectious diseases and related sciences, the journal encourages diverse contributions from experts in academic research, industry, clinical practice, public health, as well as specialists in economics, social sciences, and other relevant disciplines. By fostering a collaborative approach, Emerging Infectious Diseases aims to facilitate interdisciplinary dialogue and address the multifaceted challenges posed by infectious diseases.