Abstract
Invasive aspergillosis (IA) is a severe mycosis caused by Aspergillus species. The infection mainly affects immunocompromised patients with a significant clinical burden. This study aimed to determine the clinical and epidemiological characteristics of patients diagnosed with IA in a fourth level hospital in Colombia, as these data are scarce in the country. A retrospective, observational study, from a single center was conducted with 34 male and 32 female patients, between 1 month- and 90-year-old, diagnosed with proven (18.2%), probable (74.2%) and possible (7.6%) IA, during a 21-year period. The most frequent underlying conditions for IA were chemotherapy (39.4%) and corticosteroid use (34.8%). The lung was the most common affected organ (92.4%). Computed tomography (CT) imaging findings were mainly nodules (57.6%) and consolidation (31.8%). A low positive correlation was found between serum galactomannan and hospitalization length. Aspergillus fumigatus prevailed (73.3%) in sputum and bronchoalveolar lavage cultures. Most patients were hospitalized in general wards (63.6%) and treated with voriconazole (80.3%). Mortality rate was 15.2%. Common risk factors for IA were identified in the Colombian cohort, including medications and underlying diseases. However, their frequency differs from other countries, reinforcing the idea that local surveillance is essential and at-risk patients should be carefully monitored.
Highlights
Invasive aspergillosis (IA) is the most severe and one of the main clinical forms of aspergillosis, an opportunistic mycosis caused by species of the genus Aspergillus, a group of saprotrophic filamentous fungi that primarily inhabits the soil
In Colombia, epidemiological data about this opportunistic mycosis is at the moment scarce and the burden of the disease in the country remains underestimated
This study is, to our knowledge, the first retrospective investigation that provides clinical data and characteristics on the epidemiology of patients diagnosed with IA in a major hospital in Bogota, the capital city of Colombia
Summary
Invasive aspergillosis (IA) is the most severe and one of the main clinical forms of aspergillosis, an opportunistic mycosis caused by species of the genus Aspergillus, a group of saprotrophic filamentous fungi that primarily inhabits the soil. Depending on the virulence or pathogenicity of the species or strain, as well as on the host’s immune status and lung structure and function, Aspergillus can lead to a variety of allergic reactions and infectious diseases in immunocompromised individuals, which can progress from the respiratory system to a disseminated or invasive lethal infection [1]. It has been estimated that the incidence of IA is 5 to 25% in patients with acute leukemia, 5 to 10% in patients with allogeneic bone marrow transplantation and 0.5 to 5% in patients with cytotoxic treatment of hematological diseases, autologous bone marrow transplantation and solid organ transplantation (SOT). IA is considered an emerging mycosis in patients in intensive care units (ICU) and postoperative patients, mainly due to the dispersion of spores through hospital ventilation systems, as well as in other non-traditional at-risk groups, including patients with chronic lung diseases, with AIDS and those receiving immunomodulatory drugs [6,7,8]
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