Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Renhart,C.
Comparison of different diagnostic criteria for invasive aspergillosis in regard to epidemiology and outcome of patients
Humanmedizin; [Diplomarbeit] Medical University of Graz;2019. pp. 59
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Hönigl Martin
- Prattes Jürgen
- Altmetrics:
- Abstract:
- Background: The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) published criteria for diagnosing Invasive Aspergillosis (IA) in 2002 and 2008. There are also criteria for intensive care unit (ICU) patients without classic host factors. A single center retrospective study was performed to examine changes in epidemiology and outcome using the three criteria. Methods: From October 2011 to October 2017, 899 samples of bronchoalveolar lavage fluid (BALF) from 617 patients were taken to conduct this study. Patient data were collected using the medical data system used by the KAGes network of hospitals in Styria, Austria. Patients were categorised according to the three diagnostic criteria. Frequencies were calculated, cumulative survival was calculated using Kaplan-Meier estimators. Results: Of 617 patients, two had proven IA. According to the 2008 criteria, seven (1.1%) had probable IA compared to four (0.7%) using the 2002 criteria, three patients were non-classifiable due to missing host factors. Main underlying diseases were acute leukaemia and COPD. Four of 265 ICU patients had putative IA, two of them were non-classifiable using the 2008 criteria, due to missing host factors. Using the EORTC/MSG 2008 criteria 13 (2.1%) had possible IA vs. 26 (4.2%) using the 2002 criteria. Eight of possible IA cases using the 2002 criteria had possible IA using the revised criteria, the rest was non-classifiable due to lack of host factors or CT signs. Seven (1.1%) patients had CT signs and mycological criteria, but no host factors. Main underlying diseases were liver cirrhosis and COPD. Conclusions: Both proven IA cases were diagnosed post mortem, due to missing host factors or CT signs. Seven (1.1%) patients had probable IA. Two of four putative IA cases were missed with the EORTC criteria due to missing host factors. Possible cases were reduced, mostly due to missing host factors and CT signs. Seven (1.1%) patients showed CT signs and mycological signs, but no host factors and were thus non-classifiable. Broadening the range of host factors (liver cirrhosis, new immunosuppressive agents, COPD, influenza) and using more or more specific mycological tests might prove useful to ensure diagnosis.