A 10-year study reveals clinical and laboratory evidence for the 'semi-invasive' properties of chronic pulmonary aspergillosis.
In recent years, infections caused by Aspergillus sp. have become an emerging focus of clinical microbiology and infectious disease, as the number of patients infected with Aspergillus sp. has increased markedly. Although chronic pulmonary aspergillosis (CPA) is considered a 'semi-invasive' or 'intermediate' disease, little data are available for the direct comparison of CPA with invasive pulmonary aspergillosis (IPA) and pulmonary aspergilloma (PA) to quantify invasiveness. In this study, we compared the characteristics of CPA with those of IPA and PA among hospitalized patients over a 10-year period. A total of 29, 51 and 31 cases of CPA, IPA and PA, respectively, were included. An increasing trend in galactomannan antigen seropositivity rate from PA (24.1%) to CPA (35.7%) to IPA (54.9%) and an opposite trend for anti-Aspergillus antibody (PA (71.0%) to CPA (45.8%) to IPA (7.1%)) were observed. Eight percent of CPA patients were infected with more than one Aspergillus sp. The survival rate of the CPA group also fell between the survival rate of PA and IPA, confirming the intermediate severity of CPA. The survival rate of the CPA group became significantly higher than that of the IPA group from day 180 onwards until 2 years after admission (P<0.05). The survival rate of the CPA group remained lower than that of the PA group from day 30 onwards until 2 years after admission. Poor prognostic factors for CPA included older age (P=0.019), higher total leukocyte count (P=0.011) and higher neutrophil count (P=0.012) on admission. This study provided clinical and laboratory evidence for the semi-invasive properties of CPA.
State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China.|Department of Microbiology, The University of Hong Kong, Hong Kong, China.|Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China.|Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China.
Jasper Fuk-Woo
JF
Chan
State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China.|Department of Microbiology, The University of Hong Kong, Hong Kong, China.|Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China.|Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China.
Susanna Kar-Pui
SK
Lau
Department of Microbiology, The University of Hong Kong, Hong Kong, China.
Sally Cheuk-Ying
SC
Wong
State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China.|Department of Microbiology, The University of Hong Kong, Hong Kong, China.|Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China.|Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China.
Kelvin Kai-Wang
KK
To
Department of Microbiology, The University of Hong Kong, Hong Kong, China.
Simon Yung-Chun
SY
So
Department of Microbiology, The University of Hong Kong, Hong Kong, China.
Sally Sau-Man
SS
Leung
Department of Microbiology, The University of Hong Kong, Hong Kong, China.
Siu-Mang
SM
Chan
Department of Microbiology, The University of Hong Kong, Hong Kong, China.
Chiu-Mei
CM
Pang
Department of Microbiology, The University of Hong Kong, Hong Kong, China.
Chenlu
C
Xiao
Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China.|Department of Medicine, The University of Hong Kong, Hong Kong, China.
Ivan Fan-Ngai
IF
Hung
Department of Microbiology, The University of Hong Kong, Hong Kong, China.
Vincent Chi-Chung
VC
Cheng
State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China.|Department of Microbiology, The University of Hong Kong, Hong Kong, China.|Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China.|Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China.
Kwok-Yung
KY
Yuen
State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China.|Department of Microbiology, The University of Hong Kong, Hong Kong, China.|Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China.|Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China.
Patrick Chiu-Yat
PC
Woo
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000908:Antibodies, Fungal / Q000097:blood; D001230:Aspergillus / Q000276:immunology; D002648:Child; D002908:Chronic Disease; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D008297:Male; D008351:Mannans / Q000276:immunology; D008828:Microbiological Techniques; D008875:Middle Aged; D011379:Prognosis; D055732:Pulmonary Aspergillosis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
D000908:Antibodies, Fungal; D008351:Mannans; C012990:galactomannan; D005690:Galactose