Post-surgical invasive aspergillosis: An uncommon and under-appreciated entity - 07/08/11
, Marta Torres-Narbona a, Patricia Muñoz a, b, Teresa Peláez a, b, Emilio Bouza a, b
Corresponding author. Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, C/ Dr. Esquerdo, 46, 28007 Madrid, Spain. Tel.: +34 915867163; fax: +34 915044906.Summary |
Objective |
Post-surgical invasive aspergillosis (PSIA) is an unusual and underestimated complication of surgery. It may occur after colonization of surgical sites by airborne Aspergillus conidia during surgery, or in the immediate postoperative.
Methods |
We reviewed 7 cases of PSIA (1997–2006) and checked the air levels of Aspergillus conidia in the operating rooms and/or areas surrounding 5/7 patients.
Results |
PSIA accounted for 8.4% (n = 83) of all cases of invasive aspergillosis. Patients had no classic predisposing conditions (wound infection (n = 4), mediastinitis (n = 2), and endotipsitis with endocarditis (n = 1)). PSIA occurred sporadically after heart, thoracic, and vascular prosthetic surgery. Aspergillus fumigatus was involved in all cases. Median time from surgery to diagnosis was 25 days. Galactomannan was only positive (≥1 ng/mL) in 2 patients (endotipsitis with endocarditis and mediastinitis). Mortality was 100% in cases of organ/space post-surgical infections. Although the air of operating rooms taken before surgery was free of Aspergillus, airborne Aspergillus conidia levels were high (>95 CFU/m3) in the rooms of 2 patients.
Conclusions |
PSIA represented almost 10% of all cases of invasive aspergillosis. Our cases were not linked to high levels of Aspergillus conidia in the operating rooms but to postoperative contamination by environmental isolates present in high counts.
Le texte complet de cet article est disponible en PDF.Keywords : Post-surgical aspergillosis, Surgery, Wound infection, Mediastinitis
Plan
 | This study was partially presented at the 48th ICAAC/46th IDSA Annual Meeting, Washington, USA, 2008 (M − 2163). |
Vol 60 - N° 2
P. 162-167 - février 2010 Retour au numéro
Article précédent
- The virulence variability of different Acinetobacter baumannii strains in experimental pneumonia
- Matthieu Eveillard, Christophe Soltner, Marie Kempf, Jean-Paul Saint-André, Carole Lemarié, Catherine Randrianarivelo, Harald Seifert, Michel Wolff, Marie-Laure Joly-Guillou
- Predictors and outcomes of respiratory failure among hospitalized pneumonia patients with 2009 H1N1 influenza in Taiwan
- Yu-San Chien, Chia-Ping Su, Huai-Te Tsai, Angela S. Huang, Chia-En Lien, Min-Nan Hung, Jen-Hsiang Chuang, Hsu-Sung Kuo, Shan-Chwen Chang
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?