Clinical features and risk factors of invasive pulmonary aspergillosis in interstitial lung disease patients

作者：Yin Liu, Hanyi Jiang, Tingting Zhao, Min Cao, Jian He, Rongfeng Qi, Yonglong Xiao, Xin Su · 发表于：BMC Pulmonary Medicine · 年份：2024 · DOI：10.1186/s12890-024-03430-x · 被引用次数：6 · 研究领域：Antifungal resistance and susceptibility、Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis、Sinusitis and nasal conditions

BACKGROUND: The prevalence of invasive pulmonary aspergillosis (IPA) among patients with interstitial lung disease (ILD) is steadily increasing, leading to high mortality. The purpose of this study is to analyze the clinical features and risk factors of IPA in patients with ILD. METHODS: 353 hospitalized ILD patients admitted in Nanjing Drum Tower Hospital from March 2023 and April 2024 were enrolled. The enrolled patients were divided into the IPA group (proven and probable IPA) and non-IPA group, and the clinical characteristics and prognosis were compared between the two groups. RESULTS: Among 353 patients with ILD, 58 who suffered from IPA were identified. Among them, 2 (3.4%) episodes of proven IPA and 56 (96.6%) of probable IPA were diagnosed. The median age was 68.4 ± 8.6 years, and 35 patients were men. The forms of ILD included idiopathic pulmonary fibrosis (n = 21), interstitial pneumonia with autoimmune features (n = 13), rheumatoid arthritis related interstitial pneumonia (n = 11) and Sjögren's syndrome (n = 4). The clinical features of IPA in ILD were cough (100.0%), dyspnea (93.1%) and fever (55.2%). Chest CT images showed reticulation (87.9%), traction bronchiectasis (84.5%), GGO (77.6%), honeycombing (69.0%), consolidation (44.8%) and pleural effusion (24.1%). The incidence of honeycombing and consolidation were higher in ILD patients with IPA compared to control group (P < 0.05). The main pathogens were A. fumigatus (50.0%) and A. flavus (29.3%). Following th...