Invasive pulmonary aspergillosis in patients with severe COPD. Compative study between probable invasive infection and colonization

Ref ID: 18419

Author:

Rosana Blavia, Antonia Flor , Isabel Serra, Montse Morta, Dolores Estivill3,
Ramon Trullas, Damian Perich, Esperanza Martin, Conxa Perez,
Emilio Marquilles

Author address:

Pulmonology, Manresa Hospital – Althaia, Manresa,
Barcelona, Spain; Internal Medicine, Manresa Hospital – Althaia, Manresa,
Barcelona, Spain; Microbiology, Manresa Hospital – Althaia, Manresa,
Barcelona, Spain; Radiology, Manresa Hospital – Altahi

Full conference title:

European Respiratory Congress

Abstract:

This retrospective study included patients with chronic respiratory disease with
aspergillus isolation in respiratory cultures from Jan-07 to Dec-09. The diagnosis
of probable invasive pulmonary aspergillus (IPA) was based on compatible clinical
setting and HRCT findings. A univariate comparative analysis between IPA
probable and aspergillar colonization was carried out.
Results: Of the 103 patients registered 66 patients were excluded. Of the remaining
37 we diagnosed 15 patients (14%) with IPA probable and 22 (21%) as
colonization. COPD in 73% of patients (80% GOLD III-IV). The prior use of
corticosteroids was higher in IPA, with a greater accumulate mean 405 mgr in IPA
v 74 mgr in colonizated (p<0.05). A greater number of hospital admissions were detected in IPA. The mean length of hospital stay was higher in IPA with 35±28 days as opposed to 13±22 d. in colonization (p:0.003) and respiratory failure (80% IPA v 36% p:0.009). Antifungal therapy was received by 91% of IPA and by 36% of colonized. The overall mortality rate was 47% in IPA and 23% in colonization. Conclusions: 1. Immunosupression by corticosteroids in COPD patients Gold III-IV is the major risk factor for invasive aspergillosis.2. The absence of clinical improvement in correctly treated exacerbations of severe COPD and recurrent isolation of aspergillus in sputum should point to the possibility of the existence of IPA and demand a HRCT scan.3. HRCT findings can detect early IPA in the shape of bronchial spread once bacterial or mycobacterial infections have been ruled out.

Abstract Number: P3025

Conference Year: 2011

Link to conference website: http://www.ers-education.org/ersMade/abstract_print_11/files/Abstract_book_2011.pdf

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