Abstract

BackgroundThe clinical impact of the galactomannan (GM) test for the diagnosis of invasive pulmonary aspergillosis (IPA) is controversial. Our study evaluated the incidence and trends of IPA and GM testing in patients with aspergillus infections.MethodsWe conducted a nationwide inpatient population study using the Taiwan National Health Insurance Research Database. A total of 346 IPA (62.14% male) patients from the years 2002 to 2011 were identified for inclusion in the study.ResultsThe average incidence of IPA was 1.51 per million person-years. Over the study period, we observed an increasing trend from 0.94 to 2.06 per million person-years (P < 0.0001). We observed male predominance in IPA incidence (M/F: 1.85/1.15). Both males and females showed significantly increasing trends of IPA incidence over time (0.87 to 4.55 and 0.36 to 2.07 per million person-years for the males and females, respectively). GM testing for IPA significantly increased from 2002 to 2011, and the GM test was utilized more frequently for males than females. The increase in the incidence of IPA might be positively associated with the increase in GM testing over the past decade.ConclusionThe incidence rates of both IPA and GM testing have increased over time. GM testing is recommended for the early diagnosis of patients with suspected aspergillosis.

Highlights

  • Invasive aspergillosis infections (IAIs) result in high mortality

  • The increase in the incidence of invasive pulmonary aspergillosis (IPA) might be positively associated with the increase in GM testing over the past decade

  • This study assessed the IPA epidemiology in Taiwan over a 10 year period based on a nationwide representative database and illustrates a positive correlation between IPA incidence rate and GM test utilization

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Summary

Introduction

Invasive aspergillosis infections (IAIs) result in high mortality. The majority of IAIs have pulmonary involvement, which may be isolated (61.5~94%) [4,5] or collectively involved with multiple organs (92.9~100%) [1,3,4,5]. The most important risk factor for invasive pulmonary aspergillosis (IPA) is prolonged granulocytopenia (e.g., in HIV or hematological malignancy patients or stem cell transplant recipients). The clinical impact of the galactomannan (GM) test for the diagnosis of invasive pulmonary aspergillosis (IPA) is controversial. Our study evaluated the incidence and trends of IPA and GM testing in patients with aspergillus infections

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