Journals / Southern Clinics of Istanbul Eurasia / 2018 / Cilt: 29 - Sayı: 3

Pulmoner Enfeksiyonu Olan Hastalarda Kandida ve Aspergillus Etken Ayrımında Hangi Biyobelirteçler Yardımcı Olur?

Which Biomarkers Help to Distinguish Between Candida and Aspergillus in Patients with Pulmonary Infections?

Pages
168–175
DOI
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⚡ TL;DR(Too Long; Didn't Read)

Anahtar Sözcükler: Aspergillus; kandidiaziz; nötrofil lenfosit oranı; ortalama platelet hacmi; platelet; platelet ortalama platelet hacmi; pulmoner fungal enfeksiyonlar.

📌 3 Key Takeaways

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Objective & Hypothesis:Amaç: Çalışmada pulmoner kandidiaziz ve aspergilloziz enfeksiyonunda enflamatuvar belirteçlerden C-reaktif protein (CRP), nötrofil lenfosit oranı (NLO), platelet ve ortalama platelet hacmi (PLT/MPV), platelet lenfosit oranı (PLO) farklı olup olmadığı araştırıldı.
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Key Findings & Data:Gereç ve Yöntem: Çalışma 2016–2017 yıllarında geriye dönük kesitsel olarak yapıldı.
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Conclusion & Impact:Anahtar Sözcükler: Aspergillus; kandidiaziz; nötrofil lenfosit oranı; ortalama platelet hacmi; platelet; platelet ortalama platelet hacmi; pulmoner fungal enfeksiyonlar.
🔬Design:Research Article
📍Scope:2016–2017 Verileri
⚙️Variables:Domain Parameters

Abstract

Amaç: Çalışmada pulmoner kandidiaziz ve aspergilloziz enfeksiyonunda enflamatuvar belirteçlerden C-reaktif protein (CRP), nötrofil lenfosit oranı (NLO), platelet ve ortalama platelet hacmi (PLT/MPV), platelet lenfosit oranı (PLO) farklı olup olmadığı araştırıldı. Gereç ve Yöntem: Çalışma 2016–2017 yıllarında geriye dönük kesitsel olarak yapıldı. Hastalar hastane bilgi yönetim sisteminden (HBYS) pulmoner kandidiaziz (ICD tanı kodu B 37), pulmoner aspergilloziz (ICD tanı kodu B44) kodu ile tarandı. Yatış, çıkış hemogramları, ek hastalıkları, yatış günü, hastane mortaliteleri kaydedildi. CRP, NLO, PLT/MPV, PLO hesaplandı. Grupların kayıt edilen değerleri, enflamatuvar biyobelirteçleri karşılaştırıldı. Bulgular: Çalışmaya 44 (kandida n=19, aspergillus n=25) hasta alındı. Ortanca yaşları 65 ve 29 erkekdi (%66). Pulmoner kandidiazis ve aspergilloziz hastalarında KOAH, hastaların yatış CRP, NLO, PLO, MPV, PLT/MPV değerleri benzer idi; taburculuk sırasında CRP, PLO, NLO, PLT benzer iken taburculukta MPV pulmoner aspergillozizde, pulmoner kandidiaziz hastalarından anlamlı düşük (7.3 ve 8.4, p=0.029) idi. Sonuç: Pulmoner aspergilloziz ve kandidiaziz enfeksiyonlarında çoğu biyobelirteç benzerdi. Aspergillus tanısında PLT yüksekliği ve MPV düşüklüğü anlamlıdır. Fungal akciğer enfeksiyonu düşünülen hastalarda yapılacak olan ileriye yönelik, çok merkezli çalışmalarda benzer bulgular olması amprik tedavi başlanmasında platelet ve MPV biyobelirteçlerinin önemini artıracaktır. Anahtar Sözcükler: Aspergillus; kandidiaziz; nötrofil lenfosit oranı; ortalama platelet hacmi; platelet; platelet ortalama platelet hacmi; pulmoner fungal enfeksiyonlar.

Özet

Objective: This study was an evaluation of differences in the inflammatory markers of Creactive protein (CRP) level, the neutrophil-to-lymphocyte ratio (NLR), the platelet countto-mean platelet volume ratio (PLT/MPV), and the platelet-to-lymphocyte ratio (PLR) in patients with pulmonary candidiasis and pulmonary aspergillosis. Methods: A retrospective, cross-sectional study was performed with the data of patients who were diagnosed with pulmonary candidiasis and pulmonary aspergillosis between 2016 and 2017 according to the records of the hospital information system. The results and date of hemograms, the biochemistry values, and C-reactive protein (CRP) levels were recorded. The NLR, PLT/MPV, and PLR were calculated. The documented parameters of the study groups were compared and analyzed. Results: There were 44 patients (29 men) (candidiasis, n=19; aspergillosis, n=25), with a median age of 65 years. In both groups, the incidence of chronic obstructive pulmonary disease, level of CRP, and the NLR, PLR, MPV, and PLT/MPV were statistically similar. At discharge, the CRP, PLR, NLR, and PLT values were still similar in the 2 groups; however, the MPV was significantly lower in the pulmonary aspergillosis group when compared with the pulmonary candidiasis group (7.3 vs 8.4; p=0029). Conclusion: Most biomarkers were similar in the pulmonary aspergillosis and the candidiasis groups; however, a PLT elevation and an MPV decrease were significant in the diagnosis of aspergillus. Similar findings in prospective, multicenter studies performed with patients who are suspected of having a fungal lung infection will add to the ultimate determination of the value to be given to PLT and MPV biomarkers in the initiation of empirical treatment.

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Cite This Article

HAZAR, F. A., TÜRKER, H. (2018). Pulmoner Enfeksiyonu Olan Hastalarda Kandida ve Aspergillus Etken Ayrımında Hangi Biyobelirteçler Yardımcı Olur?. Southern Clinics of Istanbul Eurasia, Cilt: 29 - Sayı: 3, 168–175. https://ajindex.com/articles/314172

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References (14)

  1. Limper AH. Clinical approach and management for selected fungal infections in pulmonary and critical care patients. Chest 2014;146:1658–66
  2. De Pascale G, Tumbarello M. Fungal infections in the ICU: advances in treatment and diagnosis. Curr Opin Crit Care 2015;21:421–9
  3. Ener S, Ener B, Akalın H. Deep candida infections that developed in intensive çare units after long operations [Article in Turkish]. Ege Tıp Dergisi 2001;40:185–9
  4. Rødland EK, Ueland T, Pedersen TM, Halvorsen B, Muller F, Aukrust P, et al. Activation of platelets by Aspergillus fumigatus and potential role of platelets in the immunopathogenesis of Aspergillosis. Infect Immun 2010;78:1269–75
  5. Heinekamp T, Schmidt H, Lapp K, Pähtz V, Shopova I, Köster-Eiserfunke N, et al. Interference of Aspergillus fumigatus with the immune response. Semin Immunopathol 2015;37:141–52
  6. Bruns S, Kniemeyer O, Hasenberg M, Aimanianda V, Nietzsche S, Thywissen A, et al. Production of extracellular traps against Aspergillus fumigatus in vitro and in infected lung tissue is dependent on invading neutrophils and influenced by hydrophobin RodA. PLoS Pathog 2010;6:e1000873
  7. Roques M, Chretien ML, Favennec C, Lafon I, Ferrant E, Legouge C, Plocque A, et al. Evolution of procalcitonin, C-reactive protein and fibrinogen levels in neutropenic leukaemia patients with invasive pulmonary aspergillosis or mucormycosis. Mycoses 2016;59:383–90
  8. Pittet D, Monod M, Suter PM, Frenk E, Auckenthaler R. Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg 1994;220:751–8
  9. Muskett H, Shahin J, Eyres G, Harvey S, Rowan K, Harrison D. Risk factors for invasive fungal disease in critically ill adult patients: a systematic review. Crit Care 2011;15:R287
  10. Lindau S, Nadermann M, Ackermann H, Bingold TM, Stephan C, Kempf VA, et al. Antifungal therapy in patients with pulmonary Candida spp. colonization may have no beneficial effects. J Intensive Care 2015;3:31
  11. Tessier JM. Infections in the Non-Transplanted Immunocompromised Host. Surg Infect (Larchmt) 2016;17:323–8
  12. Atalay MA, Koç an, Sav H, Demir G. Antifungal Susceptibility of Aspergillus Species Isolated from Patients Diagnosed with Invasive Aspergillosis [Article in Turkish]. ANKEM Derg 2014;28:129–33
  13. Akan H. EORTC Definitions in Fungal Infections [Article in Turkish]. ANKEM Derg 2009;23:130–4
  14. Yazıcıoğlu Moçin O, Karakurt Z, Aksoy F, Güngör G, Partal M, Adıgüzel N, et al. Bronchoscopy as an indicator