624. Invasive Aspergillus Infections (IA) in Patients with Chronic Lung Disease (CLD)
Session: Abstracts: Mycology
Friday, October 22, 2010
Background: Although IA are more prevalent in immunocompromised (IC) patients, there has been an increase in IA in “non-traditional” hosts, such as patients with CLD.

Methods: We reviewed the data from 351 patients (57 CLD and 56 IC patients) with culture-proven Aspergillus infections and we compared demographics, risk factors, treatment regimens, and outcomes. These comparisons were performed using t-test, Chi-square test, and Fisher’s Exact test.

Results: Baseline demographics (age, gender, race) were similar between CLD and IC patients.  CLD patients had emphysema (61%), asthma (18%), and bronchiectasis (9%); IC patients had malignancies (27%), bone marrow transplantation (14%), and other immunosuppression disorders (11%).  A higher proportion of CLD patients had a diagnosis of IA from bronchoalveolar lavage (70% vs. 38% in IC group; p = 0.03); IC patients were primarily diagnosed by cultures of other sterile sites. The major risk factors for IA were steroid use in CLD group and neutropenia secondary to chemotherapy in the IC group. Voriconazole was the most commonly used antifungal treatment.  Overall, 53% of CLD patients vs. 69% of IC patients were cured (p = 0.14), and 55% of CLD patients vs. 47% of IC patients were alive one month after diagnosis (p = 0.75).

Conclusion: “Non-traditional” patients with IA, such as CLD patients, have outcomes and mortality that are similar to more traditional immunocompromised patients.


Subject Category: M. Mycology including clinical and basic studies of fungal infections

Speakers:
Roger Luo, Ph.D , Field-based Outcomes Research, Pfizer Inc, Collegeville, PA
Mireya Wessolossky , University of Massachusetts Memorial Health Care, Worcester, MA
Verna L. Welch, Ph.D., MPH , US Medical Affairs, Pfizer, Inc, New York, NY
Ajanta Sen, DO , University of Massachusetts Memorial, Piscataway, NJ
Tara Babu, MD , University of Massachusetts Memorial, Worcester, MA
David Luke, PharmD , Regional Medical Research Specialist, Pfizer Inc, New York, NY

Disclosures:

R. Luo, Yes
Pfizer Inc.: Employee, Salary

M. Wessolossky, None

V. L. Welch, Yes
Pfizer, Inc.: Employee and Shareholder, Salary

A. Sen, None

T. Babu, None

D. Luke, Yes
Pfizer Inc.: Employee,

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