Pre-admission fine particulate matter exposure is associated with invasive pulmonary aspergillosis in patients with severe pneumonia, results from two multicenter cohort studies

作者：Hua Zhou, Shupeng Zhu, Yujing Li, Xindie Ren, Yancheng Zhu, Xiyao Chen, Anqi Jiao, Haidong Kan, John S. Ji, Weijun Li, Chunyu Wang, Hongliu Cai, Hongyu Wang, Xiaohan Huang, Kangchen Li, Yinghe Xu, Wenxiao Zhang, Peng Shen, Xuwei He, Lin Zhong, Nan Wang, Fengqi Liu, Jin‐Fu Xu, Chao Jiang, Lingtong Huang · 发表于：EBioMedicine · 年份：2025 · DOI：10.1016/j.ebiom.2025.105971 · 被引用次数：9 · 研究领域：Indoor Air Quality and Microbial Exposure、Air Quality and Health Impacts、Chronic Obstructive Pulmonary Disease (COPD) Research

Aspergillus , the causative pathogen of invasive pulmonary aspergillosis (IPA)—a highly lethal infectious disease—produces spores with diameters that fall within the fine particulate matter (PM 2.5 ) range and are frequently detected in ambient PM 2.5 samples. In this study, we investigated whether pre-admission exposure to PM 2.5 is associated with an increased risk of IPA in patients with severe pneumonia. Daily PM 2.5 levels for the six months before admission were obtained from a multicenter retrospective cohort and a multicenter prospective cohort. Multivariable logistic regression was used to assess whether pre-admission PM 2.5 exposure is an independent risk factor of IPA in both cohorts. Pooled concentration–response curves determined the dose–response relationship. Mediation analysis was used to assess whether the presence of Aspergillus acts as a mediator between PM 2.5 exposure and 28-day mortality. Among 2287 patients, higher average daily PM 2.5 exposure over six-month before admission was independently associated with an increased risk of IPA. For every 10 μg/m 3 increase in average daily PM 2.5 exposure during the six months before admission, the risk of IPA increased by 21% (95% CI: 10%–32%). The dose–response relationship was linear, and results remained robust across subgroups and sensitivity analyses. Mediation analysis showed that Aspergillus positivity was found to mediate 21.26% (95% CI: 4.5%–48%; P = 0.008) of the relationship between daily PM 2.5 expos...