INVASIVE ASPERGILLOSIS IN INTENSIVE CARE UNIT PATIENTS  IN IRAN

Hedayati, Mohammad T.; Khodavaisy, Sadegh; Alialy, Masoud; Omran, Saeed Mahdavi; Habibi, Mohammad R.

doi:10.14712/18059694.2014.24

Acta Medica > Archive > 2013, Vol. 56 > Issue 2 > INVASIVE ASPERGILLOSIS IN INTENSIVE CARE…

Acta Med. 2013, 56: 52-56

https://doi.org/10.14712/18059694.2014.24

INVASIVE ASPERGILLOSIS IN INTENSIVE CARE UNIT PATIENTS IN IRAN

Mohammad T. Hedayati^a,b, Sadegh Khodavaisy^c, Masoud Alialy^d, Saeed Mahdavi Omran^e, Mohammad R. Habibi^f

^aMazandaran University of Medical Sciences, Sari, Iran: Department of Medical Mycology and Parasitology
^bMazandaran University of Medical Sciences, Sari, Iran: Invasive Fungi Research Center
^cKurdistan University of Medical Sciences, Sanandaj, Iran: Department of Medical Mycology and Parasitology
^dMazandaran University of Medical Sciences, Sari, Iran: Pulmonary and Critical Care Division
^eBabol University of Medical Sciences, Babol, Iran: Department of Medical Mycology and Parasitology
^fMazandaran University of Medical Sciences, Sari, Iran: Anesthesiologist and Critical Care Division

We assessed the intensive care unit (ICU) patients for Invasive aspergillosis (IA) with culture and non-culture based diagnostic methods from Iran. Thirty-six ICU patients with underlying predisposing conditions for IA were enrolled in the study. Sixty eight Bronchoalveolar lavage (BAL) samples were collected by bronchoscope twice a weekly. BAL samples were analyzed by microscopic examination, fungal culture and galactomannan (GM) detection. The Platelia Aspergillus GM EIA was used to quantify GM indices. Samples with a BAL GM index ≥1 were considered as positive for GM. Patients were classified as having probable or possible IA. Out of 36 suspected patients to IA, 36.1% of cases showed IA which were categorized as: 4 cases of possible IA and 9 of probable IA. 76.2% of BAL samples were positive for GM. From 13 patients with IA, 11 (84.6%) had at least one positive BAL GM index. Of these patients, 9 (81.8%) showed probable IA. The main underlying predisposing conditions were neutropenia (53.8%) and COPD (30.8%). Our study has indicated that COPD must be considered as one of the main predisposing condition for occurrence of aspergillosis in ICU patients. Our data have also revealed that GM detection in BAL samples play a significant role to IA diagnosis.