Invasive Tracheobronchial Aspergillosis ...
Document type :
Article dans une revue scientifique
Permalink :
Title :
Invasive Tracheobronchial Aspergillosis in Critically Ill Patients with Severe Influenza. A Clinical Trial
Author(s) :
Nyga, Remy [Auteur]
Maizel, Julien [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Nseir, Saad [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Chouaki, Taieb [Auteur]
Laboratoire de parasitologie et de mycologie médicales [CHU Amiens]
Milic, Ivona [Auteur]
Roger, Pierre-Alexandre [Auteur]
Van Grunderbeeck, Nicolas [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Lemyze, Malcolm [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Totet, Anne [Auteur]
Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 [AGIR ]
Castelain, Sandrine [Auteur]
Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 [AGIR ]
Slama, Michel [Auteur]
Dupont, Hervé [Auteur]
Université de Picardie Jules Verne [UPJV]
Sendid, Boualem [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Zogheib, Elie [Auteur]
Maizel, Julien [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Nseir, Saad [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Chouaki, Taieb [Auteur]
Laboratoire de parasitologie et de mycologie médicales [CHU Amiens]
Milic, Ivona [Auteur]
Roger, Pierre-Alexandre [Auteur]
Van Grunderbeeck, Nicolas [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Lemyze, Malcolm [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Totet, Anne [Auteur]
Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 [AGIR ]
Castelain, Sandrine [Auteur]
Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 [AGIR ]
Slama, Michel [Auteur]
Dupont, Hervé [Auteur]
Université de Picardie Jules Verne [UPJV]
Sendid, Boualem [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Zogheib, Elie [Auteur]
Journal title :
American Journal of Respiratory and Critical Care Medicine
Abbreviated title :
Am J Respir Crit Care Med
Volume number :
202
Pages :
708-716
Publisher :
American Thoracic Society
Publication date :
2020-09-01
ISSN :
1535-4970
English keyword(s) :
ICU
aspergillosis
influenza
galactomannan
(1-3)-β-d-glucan
aspergillosis
influenza
galactomannan
(1-3)-β-d-glucan
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Rationale: Invasive tracheobronchial aspergillosis (ITBA) is an uncommon but severe clinical form of invasive pulmonary aspergillosis in which the fungal infection is entirely or predominantly confined to the tracheobronchial ...
Show more >Rationale: Invasive tracheobronchial aspergillosis (ITBA) is an uncommon but severe clinical form of invasive pulmonary aspergillosis in which the fungal infection is entirely or predominantly confined to the tracheobronchial tree. Objectives: To analyze the diagnostic and prognostic differences between tracheobronchial aspergillosis and pulmonary aspergillosis without tracheobronchial lesions among patients admitted to the ICU with severe influenza. Methods: This retrospective, observational study included critically ill patients with influenza associated with pulmonary aspergillosis from three hospital ICUs between 2010 and 2019. Patient characteristics and clinical and mycologic data at admission and during ICU stay were collected in a database to evaluate variables in the two groups. Measurements and Main Results: Thirty-five patients admitted to the ICU with severe influenza and pulmonary aspergillosis were included. Ten patients were included in the group with ITBA (n = 10 of 35; 28.6%), and 25 patients were included in the group without ITBA. The group with ITBA comprised more patients with active smoking, diabetes mellitus, and higher severity scores (Simplified Acute Physiology Score II). Ninety-day mortality rates in the groups with and without ITBA were 90% and 44%, respectively (P = 0.02). Moreover, significantly higher serum 1,3-β-d-glucan and galactomannan and BAL fluid galactomannan concentrations were observed in the group with ITBA compared with the group without ITBA (P < 0.0001, P = 0.003, and P = 0.008, respectively). Conclusions: ITBA was associated with higher severity scores, mortality, and serum and BAL fluid galactomannan and 1,3-β-d-glucan concentrations than invasive pulmonary aspergillosis without tracheobronchial lesions. ITBA should be systematically researched by bronchoscopic examination in ICU patients with concomitant pulmonary aspergillosis and influenza.Show less >
Show more >Rationale: Invasive tracheobronchial aspergillosis (ITBA) is an uncommon but severe clinical form of invasive pulmonary aspergillosis in which the fungal infection is entirely or predominantly confined to the tracheobronchial tree. Objectives: To analyze the diagnostic and prognostic differences between tracheobronchial aspergillosis and pulmonary aspergillosis without tracheobronchial lesions among patients admitted to the ICU with severe influenza. Methods: This retrospective, observational study included critically ill patients with influenza associated with pulmonary aspergillosis from three hospital ICUs between 2010 and 2019. Patient characteristics and clinical and mycologic data at admission and during ICU stay were collected in a database to evaluate variables in the two groups. Measurements and Main Results: Thirty-five patients admitted to the ICU with severe influenza and pulmonary aspergillosis were included. Ten patients were included in the group with ITBA (n = 10 of 35; 28.6%), and 25 patients were included in the group without ITBA. The group with ITBA comprised more patients with active smoking, diabetes mellitus, and higher severity scores (Simplified Acute Physiology Score II). Ninety-day mortality rates in the groups with and without ITBA were 90% and 44%, respectively (P = 0.02). Moreover, significantly higher serum 1,3-β-d-glucan and galactomannan and BAL fluid galactomannan concentrations were observed in the group with ITBA compared with the group without ITBA (P < 0.0001, P = 0.003, and P = 0.008, respectively). Conclusions: ITBA was associated with higher severity scores, mortality, and serum and BAL fluid galactomannan and 1,3-β-d-glucan concentrations than invasive pulmonary aspergillosis without tracheobronchial lesions. ITBA should be systematically researched by bronchoscopic examination in ICU patients with concomitant pulmonary aspergillosis and influenza.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CNRS
CNRS
Research team(s) :
Glycobiology in fungal Pathogenesis and Clinical Applications
Submission date :
2021-07-05T09:10:56Z
2021-07-09T09:14:57Z
2021-07-09T09:14:57Z