The impact of culture isolation of Aspergillus species: A hospital-based survey of aspergillosis

J. R. Perfect, G. M. Cox, J. Y. Lee, C. A. Kauffman, L. De Repentigny, S. W. Chapman, Vicki A Morrison, P. Pappas, J. W. Hiemenz, D. A. Stevens

Research output: Contribution to journalArticlepeer-review

368 Scopus citations

Abstract

The term "aspergillosis" comprises several categories of infection: invasive aspergillosis; chronic necrotizing aspergillosis; aspergilloma, or fungus ball; and allergic bronchopulmonary aspergillosis. In 24 medical centers, we examined the impact of a culture positive for Aspergillus species on the diagnosis, risk factors, management, and outcome associated with these diseases. Most Aspergillus culture isolates from nonsterile body sites do not represent disease. However, for high-risk patients, such as allogeneic bone marrow transplant recipients (60%), persons with hematologic cancer (50%), and those with signs of neutropenia (60%) or malnutrition (30%), a positive culture result is associated with invasive disease. When such risk factors as human immunodeficiency virus infection (20%), solid-organ transplantation (20%), corticosteroid use (20%), or an underlying pulmonary disease (10%) are associated with a positive culture result, clinical judgment and better diagnostic tests are necessary. The management of invasive aspergillosis remains suboptimal: only 38% of patients are alive 3 months after diagnosis. Chronic necrotizing aspergillosis, aspergilloma, and allergic bronchopulmonary aspergillosis have variable management strategies and better short-term outcomes.

Original languageEnglish (US)
Pages (from-to)1824-1833
Number of pages10
JournalClinical Infectious Diseases
Volume33
Issue number11
DOIs
StatePublished - Dec 1 2001

Bibliographical note

Funding Information:
Financial support: Eli Lilly, Pfizer, Schering-Plough, and the National Institute of Allergy and Infectious Diseases (grant N01-AI-65296, as part of the Mycoses Study Group).

Funding Information:
We gratefully acknowledge Eli Lilly, Pfizer, and Schering-Plough for their financial support of this study.

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