Putative invasive pulmonary aspergillosis ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Putative invasive pulmonary aspergillosis in critically ill patients with chronic obstructive pulmonary disease: a matched cohort study
Auteur(s) :
Delsuc, Claire [Auteur]
Service d'anesthésie-réanimation [Centre Hospitalier Lyon Sud - HCL]
Cottereau, Aurelie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Frealle, Émilie [Auteur]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Bienvenu, Anne-Lise [Auteur]
Centre National de Référence (CNR) des Enterovirus et Parechovirus [HCL Lyon] [CNR - laboratoire associé]
Dessein, Rodrigue [Auteur]
Recherche translationnelle : relations hôte-pathogènes - EA 7366
Recherche translationelle relations hôte-pathogènes
Jarraud, Sophie [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Le Marechal, Marion [Auteur]
Maladies chroniques, santé perçue, et processus d'adaptation [APEMAC]
Wallet, Florent [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Friggeri, Arnaud [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Argaud, Laurent [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Rimmele, Thomas [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Nseir, Saad [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Lille Inflammation Research International Center - U 995 [LIRIC]
Ader, Florence [Auteur]
Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL]
Service d'anesthésie-réanimation [Centre Hospitalier Lyon Sud - HCL]
Cottereau, Aurelie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Frealle, Émilie [Auteur]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Bienvenu, Anne-Lise [Auteur]
Centre National de Référence (CNR) des Enterovirus et Parechovirus [HCL Lyon] [CNR - laboratoire associé]
Dessein, Rodrigue [Auteur]
Recherche translationnelle : relations hôte-pathogènes - EA 7366
Recherche translationelle relations hôte-pathogènes
Jarraud, Sophie [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Le Marechal, Marion [Auteur]
Maladies chroniques, santé perçue, et processus d'adaptation [APEMAC]
Wallet, Florent [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Friggeri, Arnaud [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Argaud, Laurent [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Rimmele, Thomas [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Nseir, Saad [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Lille Inflammation Research International Center - U 995 [LIRIC]
Ader, Florence [Auteur]
Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL]
Titre de la revue :
Critical care (London, England)
Nom court de la revue :
Crit. Care
Numéro :
19
Date de publication :
2015-12-03
ISSN :
1466-609X
Mot(s)-clé(s) en anglais :
Mesh:Middle Aged
Mesh:Intensive Care Units
Mesh:Humans
Mesh:Female
Mesh:Critical Illness/therapy*
Mesh:Cohort Studies
Mesh:Antifungal Agents/therapeutic use
Mesh:Aged
Mesh:80 and over
Mesh:Aged
Mesh:Invasive Pulmonary Aspergillosis/diagnosis*
Mesh:Invasive Pulmonary Aspergillosis/etiology
Mesh:Invasive Pulmonary Aspergillosis/mortality
Mesh:Male
Mesh:Prognosis
Mesh:Pulmonary Disease
Mesh:Chronic Obstructive/complications*
Mesh:Pulmonary Disease
Mesh:Chronic Obstructive/microbiology
Mesh:Pulmonary Disease
Mesh:Chronic Obstructive/mortality
Mesh:Retrospective Studies
Mesh:Risk Factors
Mesh:Intensive Care Units
Mesh:Humans
Mesh:Female
Mesh:Critical Illness/therapy*
Mesh:Cohort Studies
Mesh:Antifungal Agents/therapeutic use
Mesh:Aged
Mesh:80 and over
Mesh:Aged
Mesh:Invasive Pulmonary Aspergillosis/diagnosis*
Mesh:Invasive Pulmonary Aspergillosis/etiology
Mesh:Invasive Pulmonary Aspergillosis/mortality
Mesh:Male
Mesh:Prognosis
Mesh:Pulmonary Disease
Mesh:Chronic Obstructive/complications*
Mesh:Pulmonary Disease
Mesh:Chronic Obstructive/microbiology
Mesh:Pulmonary Disease
Mesh:Chronic Obstructive/mortality
Mesh:Retrospective Studies
Mesh:Risk Factors
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
BACKGROUND: Patients with advanced chronic obstructive pulmonary disease (COPD) are at risk for developing invasive pulmonary aspergillosis. A clinical algorithm has been validated to discriminate colonization from putative ...
Lire la suite >BACKGROUND: Patients with advanced chronic obstructive pulmonary disease (COPD) are at risk for developing invasive pulmonary aspergillosis. A clinical algorithm has been validated to discriminate colonization from putative invasive pulmonary aspergillosis (PIPA) in Aspergillus-positive respiratory tract cultures of critically ill patients. We focused on critically ill patients with COPD who met the criteria for PIPA. METHODS: This matched cohort study included critically ill patients with COPD from two university hospital intensive care units (ICUs). We studied the risk factors for PIPA as well as the impact of PIPA on short- and long-term outcomes. Whether PIPA was associated with a pattern of bacterial colonization and/or infection 6 months before and/or during ICU stay was assessed. In addition, antifungal strategies were reviewed. RESULTS: Fifty cases of PIPA in critically ill patients with COPD in the ICU were matched with one hundred control patients with COPD. The ICU short- and the long-term (at 1 year) mortality were significantly increased in the PIPA group (p < 0.001 for all variables). PIPA was a strong independent risk factor for mortality in the ICU (odds ratio 7.44, 95 % confidence interval 2.93-18.93, p < 0.001) before vasopressor therapy, renal replacement therapy, and duration of mechanical ventilation. Before ICU admission, the use of corticosteroids and antibiotics significantly increased the risk of PIPA (p = 0.004 and p < 0.001, respectively). No significant difference in bacterial etiologic agents responsible for colonization and/or infection was found between the groups. Antifungal treatment was started in 64 % of PIPA cases, with a poor impact on the overall outcome. CONCLUSIONS: PIPA was a strong death predictor in critically ill patients with COPD. The use of corticosteroids and antibiotics before ICU admission was a risk factor for PIPA. PIPA was not associated with a specific bacterial pattern of colonization or infection. Prompting antifungal treatment in critically ill patients with COPD who have PIPA may not be the only factor involved in prognosis reversal.Lire moins >
Lire la suite >BACKGROUND: Patients with advanced chronic obstructive pulmonary disease (COPD) are at risk for developing invasive pulmonary aspergillosis. A clinical algorithm has been validated to discriminate colonization from putative invasive pulmonary aspergillosis (PIPA) in Aspergillus-positive respiratory tract cultures of critically ill patients. We focused on critically ill patients with COPD who met the criteria for PIPA. METHODS: This matched cohort study included critically ill patients with COPD from two university hospital intensive care units (ICUs). We studied the risk factors for PIPA as well as the impact of PIPA on short- and long-term outcomes. Whether PIPA was associated with a pattern of bacterial colonization and/or infection 6 months before and/or during ICU stay was assessed. In addition, antifungal strategies were reviewed. RESULTS: Fifty cases of PIPA in critically ill patients with COPD in the ICU were matched with one hundred control patients with COPD. The ICU short- and the long-term (at 1 year) mortality were significantly increased in the PIPA group (p < 0.001 for all variables). PIPA was a strong independent risk factor for mortality in the ICU (odds ratio 7.44, 95 % confidence interval 2.93-18.93, p < 0.001) before vasopressor therapy, renal replacement therapy, and duration of mechanical ventilation. Before ICU admission, the use of corticosteroids and antibiotics significantly increased the risk of PIPA (p = 0.004 and p < 0.001, respectively). No significant difference in bacterial etiologic agents responsible for colonization and/or infection was found between the groups. Antifungal treatment was started in 64 % of PIPA cases, with a poor impact on the overall outcome. CONCLUSIONS: PIPA was a strong death predictor in critically ill patients with COPD. The use of corticosteroids and antibiotics before ICU admission was a risk factor for PIPA. PIPA was not associated with a specific bacterial pattern of colonization or infection. Prompting antifungal treatment in critically ill patients with COPD who have PIPA may not be the only factor involved in prognosis reversal.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
CHU Lille
CNRS
Inserm
Institut Pasteur de Lille
Université de Lille
CNRS
Inserm
Institut Pasteur de Lille
Université de Lille
Collections :
Date de dépôt :
2019-12-09T16:53:10Z
2020-04-02T10:00:38Z
2020-04-02T10:00:38Z
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