GGM试验__真菌检测.ppt

conclusion 1 The prevalence of invasive aspergillosis in the group of patients with COPD was 16.13%。 2 The 1 ng/ml cut-off showed a higher positive predictive value (100%) and comparable negative predictive value to the 0.5 ng/ml cut-off. The value of the test in COPD patients yielded similar results. * COPD patients may have increased susceptibility tofungal invasive infection for several reasons (1)structural changes in lung architecture related to the pulmonary disease; (2) the common use of long-term or repeated short-term steroid treatments as an additional immunosuppressive factor; (3) frequent hospitalisation and antibiotic treatment, leading to exposure to selected fungal pathogens; (4) co-morbidity factors such as alcoholism, diabetes mellitus or malnutrition. F. Ader.Invasive pulmonary aspergillosis in chronic obstructive pulmonary disease: an emerging fungal pathogen. Clin Microbiol Infect ,2005; 11: 427–429 * GM试验在COPD合并真菌感染诊断中的应用 * * * conclusion In COPD patients, invasive pulmonary aspergillosis currently carries a very poor prognosis. Outcome could perhaps be improved by more rapid diagnosis and prompt therapy with voriconazole. * 重度COPD患者合并侵袭性曲霉菌病的结果？ * * * E * GM test result * GM test and mortality GM test All patients(%) IPA patients(%) Non- IPA patients (%) First test positive 60 81.8 33.3 At lest one positive 54.6 83.3 20 Positive for both 72.7 87.5 33.3 * Group Mortality All patients IPA group non-IPA group Aspergillus isolated 33.3% (30/90), 73.7% (14/19), 22.5% (16/71), 70.0% (14/20). * conclusion 1 The incidence of IPA in the COPD patients admitted to the ICU was 11.1% (19/171) 2 serum GM should be tested at least twice a week to achieve early diagnosis of aspergillosis . 3 at least one positive result of two consecutive GM tests appears to be useful in the diagnosis of IPA in critically ill COPD patients in an ICU. 4 positive serum GM results combined with the isolation of Aspergillus from respiratory