title: Concomitant presence of Aspergillus fumigatus and Stenotrophomonas maltophilia in the respiratory tract: a new risk for patients with liver disease?
abstract: Concomitant lung colonization by Aspergillus fumigatus and Stenotrophomonas maltophilia was reported mainly in patients with cystic fibrosis (CF) and immunocompromised patients. The aim of the study was to assess the frequency of co-culture of A. fumigatus and S. maltophilia in respiratory samples of hospitalized patients, and to determine its associated factors. Between 2007 and 2011, all patients who had A. fumigatus in their respiratory samples were retrospectively enrolled in the study. Their clinical and laboratory data, including the presence of S. maltophilia in a respiratory sample, were collected within the same month. Of the 257 enrolled patients (372 respiratory samples), 71 % were immunocompromised and 32 % had chronic respiratory disease. S. maltophilia was isolated within the same month in 20 patients (7.8 %). In the univariate analysis, factors associated with concomitant culture of A. fumigatus and S. maltophilia were liver disease (P = 0.009), orotracheal intubation (P = 0.001), ventilator-associated pneumonia (P = 0.006), central venous catheter (P = 0.003), parenteral nutrition (P = 0.008) and culture of Pseudomonas aeruginosa in respiratory samples (P = 0.002). In the multivariate analysis, the simultaneous presence of P. aeruginosa in the respiratory tract (odds ratio (OR) = 3.19, 95 % confidence interval (CI) 1.11-9.14, P = 0.031), liver disease (OR = 3.92, 95 % CI 1.32-11.62, P = 0.014) and orotracheal intubation (OR = 3.42, 95 % CI 1.17-9.96, P = 0.024) were independently associated with the co-culture of S. maltophilia and A. fumigatus. Factors independently associated with the concomitant culture of A. fumigatus and S. maltophilia were identified. These results support a future prospective study focusing on liver disease and its complications.
authors.affiliation: Unité de Mycologie, DHU VIC, AP-HP, Hôpital Henri Mondor and Département de Microbiologie,Créteil,France.
authors.forename: Odile
authors.initials: O
authors.lastname: Cabaret
authors.affiliation: Unité de Mycologie, DHU VIC, AP-HP, Hôpital Henri Mondor and Département de Microbiologie,Créteil,France.
authors.forename: Christine
authors.initials: C
authors.lastname: Bonnal
authors.affiliation: Université Paris Est Créteil,LIC EA4393, Créteil,France.|Service de Santé publique, AP-HP, Hôpital Henri-Mondor,Créteil,France.
authors.forename: Florence
authors.initials: F
authors.lastname: Canoui-Poitrine
authors.affiliation: Unité de Bactériologie-Hygiène, DHU VIC, AP-HP, Hôpital Henri Mondor and Département de Microbiologie,Créteil,France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Emirian
authors.affiliation: Université Paris Est Créteil,LIC EA4393, Créteil,France.|Service de Santé publique, AP-HP, Hôpital Henri-Mondor,Créteil,France.
authors.forename: Geoffray
authors.initials: G
authors.lastname: Bizouard
authors.affiliation: Département d'anesthésie et de réanimation, DHU VIC, AP-HP, Hôpital Henri-Mondor,Créteil,France.
authors.forename: Eric
authors.initials: E
authors.lastname: Levesque
authors.affiliation: Unité de Pneumologie, Réanimation médicale Hôpital Henri Mondor, Centre Intercommunal de Créteil,Créteil,France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Maitre
authors.affiliation: Unité de Bactériologie-Hygiène, DHU VIC, AP-HP, Hôpital Henri Mondor and Département de Microbiologie,Créteil,France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Fihman
authors.affiliation: Unité de Bactériologie-Hygiène, DHU VIC, AP-HP, Hôpital Henri Mondor and Département de Microbiologie,Créteil,France.
authors.forename: Jean-Winoc
authors.initials: JW
authors.lastname: Decousser
authors.affiliation: Unité de Mycologie, DHU VIC, AP-HP, Hôpital Henri Mondor and Département de Microbiologie,Créteil,France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Botterel
mesh_terms: D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000150:complications / Q000382:microbiology*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000382:microbiology*; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012137:Respiratory System / Q000382:microbiology*; D012307:Risk Factors; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification*