在重症监护室通过支气管镜识别Aspergillus - - 一项基于数据的回顾性队列研究
Hsin-I Cheng1, Chun-Yu Lin1,2, Horng-Chyuan Lin1,2,3
1Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
通过支气管镜检查发现的重症监护室 (ICU) 患者的侵袭性肺阿斯伯吉洛症与死亡率的增加有关. 使用Aspergillus galactomannan抗原的早期检测可能会改善结果.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 侵袭性肺阿斯伯吉洛症 (IPA) 是重症患者死亡的重要危险因素.
- 在重症监护室 (ICU) 的IPA诊断标准旨在提高诊断的敏感性.
研究的目的:
- 为了调查ICU患者的健康结果,通过支气管镜检查确定了Aspergillus分离物.
- 为了评估Aspergillus galactomannan抗原在支气管支气管洗中的诊断性能.
主要方法:
- 使用光研究数据库进行回顾性队列研究.
- 在2017年1月至2022年12月期间接受了支气管支气管洗的ICU患者.
- 根据阳性真菌培养或Aspergillus galactomannan抗原指数>1.0.0.将患者分类为Aspergillus阳性组.
主要成果:
- 在2372名患者中,有146名患者 (6.16%) 呈阳性Aspergillus.
- 阳性阿斯珀吉勒斯菌的患者在医院死亡率较高 (58.9%与48.57%相比,P=0.016).
- 阳性Aspergillus鉴定与最近的流感,细菌性败血症和空洞化有关.
结论:
- 在ICU患者中 bronchoscopic 识别Aspergillus与死亡率升高相关.
- 通过支气管支气管洗进行Aspergillus galactomannan抗原测试可能为IPA提供更高的诊断灵敏度.
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