AB0572\u2005INVASIVE MYCOSES IN PATIENTS WITH CONNECTIVE TISSUE DISEASE FROM SOUTHERN CHINA: CLINICAL FEATURES AND ASSOCIATED FACTORS

Abstract

Background Invasive fungal disease (IFD) was well studied in patients with AIDS and organ transplant recipients. A few researches illustrated that patients with connective tissue disease (CTD) were also predisposed to IFD. However, few researches were designed to focus on invasive mycosis (IM) in patients with CTD. Objectives To investigate the clinical features and associated factors of IM in patients with CTD from Southern China. Methods A retrospective study CTD was performed. Demographic and clinical data were recorded. Associated factors were analyzed by logistic regression analysis. Results A total of 32 patients with CTD were included. The incidence of IM was 0.5% in patients with CTD (32/6911) and the highest in patients with ANCA-associated vasculitis (AAV) (7/480, 1.5%). Molds were isolated in 20 sputum specimens (20/29, 69.0%). Aspergillus spp. (81.3%) were the leading strain. Positivity of serum G-test and GM-test was 47.8% (11/23) and 34.6% (9/26), respectively. GM-test was positive in BALF from seven patients. Lung was commonly involved (30/32, 93.8%). Pulmonary nodules (46.7%) and cavitary lesions (36.7%) were common. Ten patients died (31.3%), including three with AAV (42.9%) and seven with SLE (36.8%). Multivariate logistic regression analysis showed that lymphopenia [odds ratio (OR) =3.28, 95% confidential interval (CI) 1.29-8.38, P=0.01] and median-to-high dose of glucocorticoid (GC) [OR=3.40, 95% CI 1.04-11.13, P=0.04] was associated with IM in patients with CTD. Patients with lymphopenia experienced higher risk of co-infection (50.0% vs 0%, P=0.01) and mortality (45.5% vs 0%, P=0.01) compared with patients with normal lymphocyte count. Conclusion IM tended to develop in patients with AAV, resulting in high mortality. Sputum culture could be an effective and non-invasive method to diagnose IM. Lymphopenia, and median-to-high dose of GC are associated with IM in patients with CTD. Acknowledgement: no Disclosure of Interests None declared