Allergic bronchopulmonary aspergillosis: Reactivity of IgE and IgG antibodies with antigenic components of Aspergillus fumigatus (IgE/IgG antigen complexes)

Sera of patients with ABPA were tested by XRIE tests incorporating their own serum (self-XRIE) to detect the presence of IgG/IgE antigen complexes to a “reference” Aspergillus fumigatus preparation. Of the 32 sera studied, 29 (90%) had visible precipitin (IgG) peaks, and 27 of these 29 as well as the three apparently precipitin-negative sera, i.e., 30 (94%), showed binding of specific IgE by autoradiography. The two precipitin-positive sera that did not show IgE binding were also skin test negative and RAST negative to this A. fumigatus antigen. Specific IgG as determined in ELISA correlated well with the grading of the XIE precipitin peaks (p < 0.05). There was also a highly significant correlation between specific IgE by RAST and grading the radioactive uptake seen in the autoradiograph (p < 0.001) indicating, for each serum, the presence of IgG antibodies to most of the components to which there was specific IgE. In the self-XRIE tests there was considerable variation of reactivity from serum to serum, in numbers of antigen/antibody peaks observed, in relative peak heights, and in the intensity of the respective staining. By comparing each test to a “reference” pattern developed with the use of an ABPA serum pool, the antigenic components of A. fumigatus were found to be of two main types: (1) antigens that appeared to be poorly precipitating (possibly low-molecular-weight components) but showed strong IgE binding (these were apparently major allergenic components and with one exception proved to be the faster migrating components) and (2) antigens that produced the strongest precipitin reactions with only weak binding of specific IgE and therefore minor allergenic components.     

心胸外科患者多重耐药菌感染及危险因素分析

目的探讨心胸外科住院患者多重耐药菌(MDRO)感染的特征及其危险因素。方法回顾性调查632例发生医院感染的心胸外科患者,根据其是否发生MDRO感染分为MDRO组和非MDRO组,计算MDRO感染率并分析多重耐药菌株分布,筛选影响心胸外科患者MDRO感染的相关危险因素。结果心胸外科患者MDRO感染发生率为15.19%(96/632),多重耐药菌株以鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌等为主;多因素分析结果显示,影响心胸外科患者MDRO感染的危险因素包括年龄(OR=2.094)、基础疾病(OR=3.056)、机械通气(OR=4.158)、留置导管(OR=4.914)、低白蛋白血症(OR=5.197)、联合使用广谱抗菌药物(OR=3.536)、频繁更换抗菌药物(OR=4.272)等。结论心胸外科医院感染患者中具有较高的MDRO感染发生比例,影响其发生MDRO感染的危险因素较多,应尽早采取预防措施,降低MDRO感染发生率。