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01.12.2014 | Research | Ausgabe 1/2014 Open Access

Respiratory Research 1/2014

Importance of Aspergillus spp. isolation in Acute exacerbations of severe COPD: prevalence, factors and follow-up: the FUNGI-COPD study

Zeitschrift:
Respiratory Research > Ausgabe 1/2014
Autoren:
Arturo Huerta, Nestor Soler, Mariano Esperatti, Mónica Guerrero, Rosario Menendez, Alexandra Gimeno, Rafael Zalacaín, Nuria Mir, Jose Maria Aguado, Antoni Torres
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1465-9921-15-17) contains supplementary material, which is available to authorized users.
Arturo Huerta, Nestor Soler contributed equally to this work.

Competing interests

This work in original and all authors meet the criteria for authorship, including acceptance of responsibility for the scientific content of the manuscript. NM is actually employed by Pfizer Pharmaceuticals Spain but did not influence the interpretation of the data analysis.

Authors’ contributions

Study concept and design: NS, AT. Coordination of the acquisition of the data: AH, ME, AM, MG, RZ. Data analysis: NS, AH, NM. Data interpretation: NS, AT, NM, JMA. Writing the article: AH, NS, AT. Critical revision of the manuscript: AH, AT, RM, NS. All authors read and approved the final manuscript.

Abstract

Background

Acute exacerbations of COPD (AECOPD) are often associated with infectious agents, some of which may be non-usual, including Aspergillus spp. However, the importance of Aspergillus spp. in the clinical management of AECOPD still remains unclear.

Objectives

The aims of the study were to analyze the prevalence and risk factors associated with Aspergillus spp. isolation in AECOPD, and to investigate the associated clinical outcomes during a 1-year follow-up period.

Methods

Patients presenting with an AECOPD requiring hospitalization were prospectively included from four hospitals across Spain. Clinical, radiological and microbiological data were collected at admission and during the follow-up period (1, 6 and 12 months after discharge), and re-admissions and mortality data collected during the follow-up.

Results

A total of 240 patients with severe AECOPD were included. Valid sputum samples were obtained in 144 (58%) patients, and in this group, the prevalence of Aspergillus spp. isolation was 16.6% on admission and 14.1% at one-year follow-up. Multivariate logistic-regression showed that AECOPD in the previous year (OR 12.35; 95% CI, 1.9-29.1; p < 0.001), concurrent isolation of pathogenic bacteria (OR 3.64; 95% CI 1.65-9.45, p = 0.001) and concomitant isolation of Pseudomonas aeruginosa (OR 2.80; 95% IC, 1.81-11.42; p = 0.001) were the main risk factors for Aspergillus spp. isolation.

Conclusions

The main risk factors for Aspergillus spp. isolation were AECOPD in the previous year and concomitant isolation of Pseudomonas aeruginosa. However, although Aspergillus spp. is often isolated in sputum samples from patients with AECOPD, the pathogenic and clinical significance remains unclear.
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