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New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study

Chronic pulmonary aspergillosis (CPA) has been reported to be associated with poor prognosis in non-tuberculous mycobacteria (NTM)-pulmonary disease (PD) patients. However, whether isolation of Apergillus species is associated with poor outcome or mostly just the reflection of colonization is a wide...

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Autores principales: Fukushima, Kiyoharu, Kida, Hiroshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912930/
https://www.ncbi.nlm.nih.gov/pubmed/33525485
http://dx.doi.org/10.3390/microorganisms9020270
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author Fukushima, Kiyoharu
Kida, Hiroshi
author_facet Fukushima, Kiyoharu
Kida, Hiroshi
author_sort Fukushima, Kiyoharu
collection PubMed
description Chronic pulmonary aspergillosis (CPA) has been reported to be associated with poor prognosis in non-tuberculous mycobacteria (NTM)-pulmonary disease (PD) patients. However, whether isolation of Apergillus species is associated with poor outcome or mostly just the reflection of colonization is a widely debated issue and a yet unsolved question. We conducted this single-centered retrospective cohort study of 409 NTM-PD patients to assess the impacts and prevalence of Aspergillus isolation and CPA development. The median observation time was 85 months. Aspergillus species were isolated from 79 (19.3%) and 23 (5.6%) developed CPA. Isolation of Aspergillus species was not associated with mortality in NTM-PD patients (p = 0.9016). Multivariate logistic regression analysis revealed that higher CRP (p = 0.0213) and AFB stain positivity (p = 0.0101) were independently associated with Aspergillus isolation. Different mycobacterial species were not associated with Aspergillus isolation. Survival curves for patients with CPA diagnosis were significantly and strikingly different from those without (p = 0.0064), suggesting that CPA development severely affects clinical outcome. Multivariate logistic regression analysis revealed that the use of systemic steroids (p = 0.0189) and cavity (p = 0.0207) were independent risk factors for the progression to CPA. Considering the high mortality rate of CPA in NTM-PD, early diagnosis and treatment are essential to improve outcomes for NTM-PD patients.
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spelling pubmed-79129302021-02-28 New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study Fukushima, Kiyoharu Kida, Hiroshi Microorganisms Article Chronic pulmonary aspergillosis (CPA) has been reported to be associated with poor prognosis in non-tuberculous mycobacteria (NTM)-pulmonary disease (PD) patients. However, whether isolation of Apergillus species is associated with poor outcome or mostly just the reflection of colonization is a widely debated issue and a yet unsolved question. We conducted this single-centered retrospective cohort study of 409 NTM-PD patients to assess the impacts and prevalence of Aspergillus isolation and CPA development. The median observation time was 85 months. Aspergillus species were isolated from 79 (19.3%) and 23 (5.6%) developed CPA. Isolation of Aspergillus species was not associated with mortality in NTM-PD patients (p = 0.9016). Multivariate logistic regression analysis revealed that higher CRP (p = 0.0213) and AFB stain positivity (p = 0.0101) were independently associated with Aspergillus isolation. Different mycobacterial species were not associated with Aspergillus isolation. Survival curves for patients with CPA diagnosis were significantly and strikingly different from those without (p = 0.0064), suggesting that CPA development severely affects clinical outcome. Multivariate logistic regression analysis revealed that the use of systemic steroids (p = 0.0189) and cavity (p = 0.0207) were independent risk factors for the progression to CPA. Considering the high mortality rate of CPA in NTM-PD, early diagnosis and treatment are essential to improve outcomes for NTM-PD patients. MDPI 2021-01-28 /pmc/articles/PMC7912930/ /pubmed/33525485 http://dx.doi.org/10.3390/microorganisms9020270 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fukushima, Kiyoharu
Kida, Hiroshi
New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study
title New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study
title_full New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study
title_fullStr New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study
title_full_unstemmed New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study
title_short New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study
title_sort new/different look at the presence of aspergillus in mycobacterial pulmonary diseases. long-term retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912930/
https://www.ncbi.nlm.nih.gov/pubmed/33525485
http://dx.doi.org/10.3390/microorganisms9020270
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