两个医院的故事:在西班牙第四次大流行浪潮期间,比较两家ICU的CAPA感染情况
Miguel Ángel Sánchez-Castellano1, Cristina Marcelo2, Javier Marco3
1Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain. mscastellano@salud.madrid.org.
Mycopathologia
|May 31, 2023
概括
与COVID-19相关的肺阿斯伯吉洛症 (CAPA) 是重症患者的一种严重并发症. 这项研究发现CAPA的发病率为6.3%,高死亡率为66.6%,表明需要有效的抗真菌策略.
科学领域:
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
- 临界护理医学 临界护理医学
背景情况:
- 与COVID-19相关的肺阿斯伯吉洛症 (CAPA) 对严重的COVID-19患者构成重大风险.
- CAPA与并发症和死亡率的增加有关,特别是在重症监护室 (ICU) 设置中.
研究的目的:
- 在两个不同的ICU队列中比较CAPA的诊断和临床特征.
- 为了评估严重的COVID-19患者中CAPA的发生率,诊断和结果.
主要方法:
- 马德里两组ICU队伍 (2021年2月至6月) 进行的严重COVID-19的比较研究.
- 患者使用修改的ECMM/ISHAM共识标准进行CAPA分类,包括气管支气管吸附剂.
- 收集了临床和微生物学数据用于诊断和结果评估.
主要成果:
- 观察到全球CAPA发病率为6.3%,中位数诊断时间为ICU入院后14天.
- 复杂的Aspergillus fumigatus是主要发现的物种.
- 在一个队列中,CAPA患者的整体死亡率为66.6%,明显高于非CAPA患者.
结论:
- 在CAPA发病率方面没有发现有意义的医院间差异.
- 抗真菌疗法,包括阿佐尔和安福特里辛B,显示出潜在的有效性,因为治疗差异与死亡率变化无关.
- 对CAPA有效的管理策略对于改善重症COVID-19患者的治疗结果至关重要.
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