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Clinical characteristics of patients with coronavirus disease 2019-associated pulmonary aspergillosis on mechanical ventilation: A single-center retrospective study in Japan.
Ogawa, Yoshihiko; Murata, Kenya; Hasegawa, Kohei; Nishida, Koji; Gohma, Iwao; Kasahara, Kei.
  • Ogawa Y; Department of Infectious Diseases, Sakai City Medical Center, Sakai, Osaka, Japan. Electronic address: hikoichi.ogw@gmail.com.
  • Murata K; Department of Infectious Diseases, Sakai City Medical Center, Sakai, Osaka, Japan.
  • Hasegawa K; Department of Infectious Diseases, Sakai City Medical Center, Sakai, Osaka, Japan.
  • Nishida K; Department of Respiratory Medicine, Sakai City Medical Center, Sakai, Osaka, Japan.
  • Gohma I; Department of Respiratory Medicine, Sakai City Medical Center, Sakai, Osaka, Japan.
  • Kasahara K; Center for Infectious Diseases, Nara Medical University, Nara, Japan.
J Infect Chemother ; 2022 Nov 12.
Article in English | MEDLINE | ID: covidwho-2105376
ABSTRACT

BACKGROUND:

Aspergillus is one of the important pathogens that contribute to high mortality in patients with coronavirus disease 2019 (COVID-19) in intensive care units (ICUs). Although incidence rates of Aspergillus coinfection are high globally, a Japanese national survey reported a low incidence. This study aimed to describe the clinical characteristics of patients with COVID-19-associated pulmonary aspergillosis at our institute.

METHODS:

We identified patients with microbiologically confirmed COVID-19 on mechanical ventilation in the ICU. Of these patients, we identified patients in whom Aspergillus was cultured from the respiratory specimen.

RESULTS:

Of a total of 169 patients, seven had aspergillosis (4.1%), which included three patients, three patients, and one patient with possible, probable, and proven aspergillosis, respectively, according to the criteria of the European Confederation of Medical Mycology International Society. All patients received systemic steroid therapy. Two patients (one each with proven and probable aspergillosis) had tracheobronchitis diagnosed by bronchoscopy. All patients in whom Aspergillus was repeatedly isolated from samples died. The mortality rates for all cases and probable and proven cases were 57% (4/7) and 75% (3/4), respectively.

CONCLUSIONS:

The incidence rate of aspergillosis in patients with COVID-19 in the ICU was higher in our institute than that reported by a Japanese national survey (4.1% vs. 0.5%). Repeated detection of Aspergillus might suggest a true Aspergillus infection, such as chronic aspergillosis, rather than colonization. In patients with severe COVID-19 patients, it is important to always keep CAPA in mind.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal subject: Microbiology / Drug Therapy Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal subject: Microbiology / Drug Therapy Year: 2022 Document Type: Article