Pentraxin-3 as a novel prognostic biomarker in non-neutropenic invasive pulmonary aspergillosis patients

作者：Chao Sun, Xiaomin Cai, Huanhuan Zhong, Yajie Lu, Yuanyuan Li, Yuchen Cai, Yujie Wang, Tingting Zhao, Min Cao, Li Wang, Chunlai Feng, Wenkui Sun, Cheng Chen, Yujian Tao, Guoer Ma, Binchan He, Xinyu Wang, Jinjin Zhong, Xin Lu, Yuanqin Li, Xin Su · 发表于：Microbiology Spectrum · 年份：2025 · DOI：10.1128/spectrum.02945-24 · 被引用次数：7 · 研究领域：Antifungal resistance and susceptibility、Infective Endocarditis Diagnosis and Management、Pleural and Pulmonary Diseases

ABSTRACT The incidence of invasive pulmonary aspergillosis (IPA) in non-neutropenic patients is increasing. This study aimed to evaluate the clinical outcomes and risk factors for mortality in non-neutropenic IPA patients. We conducted a prospective, multicenter study from August 2020 to February 2024, enrolling 565 patients with suspected IPA. The study cohort comprised 195 IPA (non-neutropenic) cases and 370 non-IPA cases. Peripheral blood and bronchoalveolar lavage fluid (BALF) specimens were collected to measure pentraxin-3 (PTX3) levels. Additionally, demographic data, clinical characteristics, and antifungal therapy of each patient were recorded. We analyzed factors associated with 30- and 90-day mortality. IPA patients exhibited higher mortality rates compared to non-IPA patients, with 30-day rates of 26.15% versus 8.38% ( P < 0.001) and 90-day rates of 34.36% versus 13.24% ( P < 0.001). Higher plasma and BALF PTX3 levels were associated with poor prognosis in IPA patients. ROC curve analysis identified optimal PTX3 thresholds of 4.29 ng/mL in BALF (sensitivity, 67.1%; specificity, 81.4%) and 7.11 ng/mL in plasma (sensitivity, 73.4%; specificity, 82.8%) for predicting mortality. Multivariate Cox regression analysis confirmed PTX3 levels in plasma (hazard ratio [HR] 3.87, 95%CI [1.87–8.00], P ＜0.001) and BALF (HR 2.40 [1.19–4.84], P = 0.014) were independent prognostic factors for IPA mortality. Additionally, positive galactomannan test results in both BALF and pl...