Clinical risk factors and bronchoscopic features of invasive aspergillosis in Intensive care unit patients

Ref ID: 17963

Author:

S. Khodavaisy, M. T. Hedayati, M. Alialy and M. R. Habibi

Author address:

Tehran University of Medical Sciences, Tehran, Iran,Kurdistan
University of Medical Sciences, Sanandaj, Iran; Mazandaran
University of Medical Sciences, Sari, Iran

Full conference title:

18th International Society for Human and Animal Mycology

Date: 11 June 2014

Abstract:

Invasive aspergillosis (IA) is an important cause of morbidity and
mortality in immunocompromised patients. During recent years, a
rising incidence of IA in ICU patients has been reported. The patterns of
IA related infection may differ according to the type of underlying
disease. Unfortunately little is known about the characteristics of IA in
ICU patients. In the present study we assessed IA related clinical and
bronchoscopy findings in ICU patients. This study was performed at the
ICU units in Sari, Mazandaran from August 2009 through September
2010. We retrospectively analysed 43 ICU patients with underlying
predisposing conditions. Bronchoalveolar lavage (BAL) samples were
collected by bronchoscope twice a weekly. The samples were analyzed
by culture and non-culture based diagnostic methods for the occurrence
of IA. Patients were assigned a probable or possible diagnosis of
IA according to the consensus definition of the EORTC/MSG. Out of 43
suspected patients to IA, 13 (36.1%) cases showed IA. According to
criteria presented by EORTC/MSG, they were categorized as: 4 cases
(30.8%) of possible IA and 9 (69.2%) of probable IA. The observed
mortality was 61.5%. The main underlying predisposing conditions
were neutropenia(53.8%), COPD(30.8%) and hematologic malignancy
(15.4%). The macroscopic finding in bronchoscopy included of Prulent
secretion (46.6%), Mucosal bleeding (33.3%), Mucosal erythema
(26.6%), Trachobronchomalasia (13.3%). The diagnosis of IA in
patients with critical illness in ICU is even more difficult. The clinical
diagnostic process is often dependent on indirect circumstantial data
enhancing the probability of IA. Bronchoscopy with inspection of the
tracheobronchial tree, sampling of deep airway secretions and BAL can
be helpful.

Abstract Number: P312

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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