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Clinical significance of Aspergillus species isolated from respiratory specimens in patients with Mycobacterium avium complex lung disease

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Abstract

Chronic pulmonary aspergillosis (CPA) is associated with mortality in patients with Mycobacterium avium complex lung disease (MAC-LD). An Aspergillus-positive respiratory specimen often reflects colonization, and thus the clinical significance of Aspergillus isolation in MAC-LD patients is not well understood. The objective of this study was to investigate the clinical characteristics and outcomes of MAC-LD patients in whom Aspergillus was isolated from respiratory specimens. We performed a retrospective review of the medical records of 329 MAC-LD patients. We compared the characteristics and mortality rates between patients with Aspergillus isolation and those without. All Aspergillus species detected from respiratory specimens within the follow-up period were reviewed. Aspergillus was detected in 40 (12.2%) of the 329 patients. There were no significant differences in the clinical characteristics and mortality rates between patients with and without Aspergillus isolation. Among the 40 patients with Aspergillus isolation, 9 (22.5%) developed CPA. CPA was most often caused by A. fumigatus. In the 40 Aspergillus-positive patients, patients with A. fumigatus isolation had a significantly higher mortality rate than those without (P < 0.001). The multivariate Cox proportional hazards model showed older age (P = 0.050), presence of respiratory comorbidities (P = 0.008), hypoalbuminemia (P < 0.001), and isolation of A. fumigatus (P = 0.005) to be prognostic factors for mortality in MAC-LD patients. There was no significant difference in the mortality rates between patients with Aspergillus isolation and those without. However, isolation of A. fumigatus may be associated with poor prognosis in MAC-LD patients.

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Funding

No financial support was received for this study.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Ohara Memorial Kurashiki Healthcare Foundation, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan

    K. Furuuchi, A. Ito, T. Hashimoto & T. Ishida

  2. Division of Cancer Immunology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan

    S. Kumagai

Authors
  1. K. Furuuchi
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  2. A. Ito
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  3. T. Hashimoto
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  4. S. Kumagai
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  5. T. Ishida
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Corresponding author

Correspondence to K. Furuuchi.

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Conflict of interest

Tadashi Ishida has received honoraria from Pfizer Japan Inc. The other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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For this type of study formal consent is not required.

Data availability

The datasets used and analyzed during this study are available from the corresponding author upon request.

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Furuuchi, K., Ito, A., Hashimoto, T. et al. Clinical significance of Aspergillus species isolated from respiratory specimens in patients with Mycobacterium avium complex lung disease. Eur J Clin Microbiol Infect Dis 37, 91–98 (2018). https://doi.org/10.1007/s10096-017-3105-6

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  • DOI: https://doi.org/10.1007/s10096-017-3105-6

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