Aspergillus identification through bronchoscope in intensive care unit – a retrospective, databased cohort study
IntroductionInvasive pulmonary aspergillosis (IPA) increases the risk of mortality of critically ill patients. Diagnostic criteria specifically targeting patients in intensive care units(ICUs) have been developed to improve diagnostic sensitivity. This study investigated health outcomes among patien...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2024.1471298/full |
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| author | Hsin-I Cheng Chun-Yu Lin Chun-Yu Lin Horng-Chyuan Lin Horng-Chyuan Lin Horng-Chyuan Lin Shu-Min Lin Shu-Min Lin Shu-Min Lin Shu-Min Lin Meng-Heng Hsieh Meng-Heng Hsieh Yueh-Fu Fang Yueh-Fu Fang Po-Jui Chang Po-Jui Chang Wei-Syun Hung Ko Cheng Chung−Chi Huang Chung−Chi Huang |
| author_facet | Hsin-I Cheng Chun-Yu Lin Chun-Yu Lin Horng-Chyuan Lin Horng-Chyuan Lin Horng-Chyuan Lin Shu-Min Lin Shu-Min Lin Shu-Min Lin Shu-Min Lin Meng-Heng Hsieh Meng-Heng Hsieh Yueh-Fu Fang Yueh-Fu Fang Po-Jui Chang Po-Jui Chang Wei-Syun Hung Ko Cheng Chung−Chi Huang Chung−Chi Huang |
| author_sort | Hsin-I Cheng |
| collection | DOAJ |
| description | IntroductionInvasive pulmonary aspergillosis (IPA) increases the risk of mortality of critically ill patients. Diagnostic criteria specifically targeting patients in intensive care units(ICUs) have been developed to improve diagnostic sensitivity. This study investigated health outcomes among patients in ICUs with Aspergillus isolates identified using bronchoscopy.MethodsThis retrospective cohort study obtained data from the Chang Gung Research Database of Chang Gung Memorial Hospital. Patients admitted to the ICU between January 2017 and December 2022 who received bronchoalveolar lavage were enrolled. Patients with a fungus culture yielding Aspergillus spp. isolates or who had an Aspergillus galactomannan antigen index value of >1.0 were categorized into the Aspergillus-positive group.ResultsA total of 2372 patients were enrolled, and 146 patients (6.16%) tested positive for Aspergillus. Of the patients who tested positive for Aspergillus, 37.67% had a positive culture result, and 77.4% had a positive galactomannan antigen result. Patients with Aspergillus isolates were more likely to have a recent influenza infection, concurrent bacterial sepsis, and a cavitation and to die in hospital (in-hospital mortality rate 58.9% vs. 48.57%, P = 0.016).DiscussionIdentifying Aspergillus through bronchoscopy in the ICU is associated with higher mortality rates than in patients who test negative for Aspergillus. Galactomannan antigen from bronchoalveolar lavage may provide higher diagnostic sensitivity. |
| format | Article |
| id | doaj-art-68b512cab7de4c7bae611ec428549d0b |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-68b512cab7de4c7bae611ec428549d0b2025-01-13T06:11:06ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-01-011410.3389/fcimb.2024.14712981471298Aspergillus identification through bronchoscope in intensive care unit – a retrospective, databased cohort studyHsin-I Cheng0Chun-Yu Lin1Chun-Yu Lin2Horng-Chyuan Lin3Horng-Chyuan Lin4Horng-Chyuan Lin5Shu-Min Lin6Shu-Min Lin7Shu-Min Lin8Shu-Min Lin9Meng-Heng Hsieh10Meng-Heng Hsieh11Yueh-Fu Fang12Yueh-Fu Fang13Po-Jui Chang14Po-Jui Chang15Wei-Syun Hung16Ko Cheng17Chung−Chi Huang18Chung−Chi Huang19Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Respiratory Therapy, Chang Gung Memorial Hospital, Taoyuan, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Respiratory Therapy, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Medicine, National Tsing Hua University, Hsin-Chu, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Medicine, Chang Gung University, Taoyuan, TaiwanIntroductionInvasive pulmonary aspergillosis (IPA) increases the risk of mortality of critically ill patients. Diagnostic criteria specifically targeting patients in intensive care units(ICUs) have been developed to improve diagnostic sensitivity. This study investigated health outcomes among patients in ICUs with Aspergillus isolates identified using bronchoscopy.MethodsThis retrospective cohort study obtained data from the Chang Gung Research Database of Chang Gung Memorial Hospital. Patients admitted to the ICU between January 2017 and December 2022 who received bronchoalveolar lavage were enrolled. Patients with a fungus culture yielding Aspergillus spp. isolates or who had an Aspergillus galactomannan antigen index value of >1.0 were categorized into the Aspergillus-positive group.ResultsA total of 2372 patients were enrolled, and 146 patients (6.16%) tested positive for Aspergillus. Of the patients who tested positive for Aspergillus, 37.67% had a positive culture result, and 77.4% had a positive galactomannan antigen result. Patients with Aspergillus isolates were more likely to have a recent influenza infection, concurrent bacterial sepsis, and a cavitation and to die in hospital (in-hospital mortality rate 58.9% vs. 48.57%, P = 0.016).DiscussionIdentifying Aspergillus through bronchoscopy in the ICU is associated with higher mortality rates than in patients who test negative for Aspergillus. Galactomannan antigen from bronchoalveolar lavage may provide higher diagnostic sensitivity.https://www.frontiersin.org/articles/10.3389/fcimb.2024.1471298/fullAspergillusinvasive pulmonary aspergillosis (IPA)galactomannan (GM)intensive care unit (ICU)broncho alveolar lavage (BAL) |
| spellingShingle | Hsin-I Cheng Chun-Yu Lin Chun-Yu Lin Horng-Chyuan Lin Horng-Chyuan Lin Horng-Chyuan Lin Shu-Min Lin Shu-Min Lin Shu-Min Lin Shu-Min Lin Meng-Heng Hsieh Meng-Heng Hsieh Yueh-Fu Fang Yueh-Fu Fang Po-Jui Chang Po-Jui Chang Wei-Syun Hung Ko Cheng Chung−Chi Huang Chung−Chi Huang Aspergillus identification through bronchoscope in intensive care unit – a retrospective, databased cohort study Frontiers in Cellular and Infection Microbiology Aspergillus invasive pulmonary aspergillosis (IPA) galactomannan (GM) intensive care unit (ICU) broncho alveolar lavage (BAL) |
| title | Aspergillus identification through bronchoscope in intensive care unit – a retrospective, databased cohort study |
| title_full | Aspergillus identification through bronchoscope in intensive care unit – a retrospective, databased cohort study |
| title_fullStr | Aspergillus identification through bronchoscope in intensive care unit – a retrospective, databased cohort study |
| title_full_unstemmed | Aspergillus identification through bronchoscope in intensive care unit – a retrospective, databased cohort study |
| title_short | Aspergillus identification through bronchoscope in intensive care unit – a retrospective, databased cohort study |
| title_sort | aspergillus identification through bronchoscope in intensive care unit a retrospective databased cohort study |
| topic | Aspergillus invasive pulmonary aspergillosis (IPA) galactomannan (GM) intensive care unit (ICU) broncho alveolar lavage (BAL) |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2024.1471298/full |
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