Analysis of risk factors for invasive pulmonary aspergillosis secondary to fever with thrombocytopenia syndrome

doi:10.19871/j.cnki.xfcrbzz.2024.05.008

Abstract

Abstract: Objective To explore the risk factors associated with Invasive Pulmonary Aspergillosis（IPA） secondary to Severe fever with thrombocytopenia syndrome（SFTS）through retrospective analysis. Method A total of 109 patients with SFTS were confirmed in the Second Hospital of Nanjing from January 2020 to November 2023. There were 14 cases with IPA and 95 cases without IPA. SPSS 26.0 was used for univariate and multivariate analysis, general data, inflammatory and immune indicators, and degree of organ damage between the two groups were compared. Result All 109 patients were sporadic, 50 males and 59 females, with a median age of onset of 68 years. In univariate analysis, the levels of procalcitonin, C-reactive protein, serum interleukin 6, CD3⁺T lymphocytes, CD4⁺T lymphocytes and CD45 lymphocytes in the IPA group, as well as the proportion of mechanical ventilation, blood purification and vasoactive drug treatment in the none-IPA group were lower than those in the IPA group (P<0.05), while the serum albumin levels in the none-IPA group were significantly higher than those in the IPA group (P<0.05). Logistic regression analysis showed that serum albumin and mechanical ventilation were influencing factors for IPA (P<0.05), serum albumin level (odds ratio=0.78) was a protective factor for the development of IPA, and mechanical ventilation therapy (odds ratio=9.80) was a risk factor for the development of IPA. ROC multiplex analysis showed that the combination of mechanical ventilation and a decrease in serum albumin levels could be used to predict the occurrence of IPA (AUC=0.845). Conclusion mechanical ventilation and decreased serum albumin levels are independent risk factors for the development of IPA, which can be used alone or in combination to predict the occurrence of IPA in patients with SFTS. In addition, it provides a clinical reference for preventing the occurrence of IPA, preemptive antifungal therapy, and reducing the mortality rate.

Key words: Severe fever with thrombocytopenia syndrome, Invasive pulmonary Aspergillosis, Mechanical ventilation, Serum albumin

CLC Number:

R512.8

Chen Jun, Xiao Lingyan, Shi Dongyang, Liu Yongfu, Yang Kai, Cui Daguang, Zheng Yishan. Analysis of risk factors for invasive pulmonary aspergillosis secondary to fever with thrombocytopenia syndrome[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(5): 42-46.

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