Correction: Galactomannan Testing and the Incidence of Invasive Pulmonary Aspergillosis: A 10-Year Nationwide Population-Based Study in Taiwan

Sun, Kuo-Shao; Tsai, Chang‐Youh; Chen, Solomon Chih–Cheng; Chen, Yih-Yuan; Huang, Erick Wan-Chun

doi:10.1371/journal.pone.0156566

Cited by 5 publications

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“…other than serum and plasma by a commercially based enzyme immunoassay, and β-glucan serum, and fungal DNA in body fluids by PCR for diagnosis of IPA have shown a tremendously overwhelmingly response. [ 7 8 9 10 11 ]…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of galactomannan test with bronchoalveolar lavage and serum for the diagnosis of invasive aspergillosis in patients with hematological malignancies

et al. 2017

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INTRODUCTION:Invasive pulmonary aspergillosis (IPA) is a major cause of morbidity and mortality in patients with hematological malignancies. In recent years, testing for values of galactomannan (GM) in serum and bronchoalveolar lavage (BAL) fluid has been investigated as a diagnostic test for IPA for such patients, but global experience and consensus on optical density (OD) cutoffs, especially for BAL galactomannan remains lacking.METHODS:We performed a prospective case–control study to determine an optimal BAL GM OD cutoff for IPA in at-risk patients. Cases were subjects with hematological diagnoses who met established revised definitions for proven or probable IPA established by the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group (EORTC/MSG, 2008), without the use of BAL GM results. Exclusion criteria included the use of piperacillin/tazobactam and use of antifungals that were active against Aspergillus spp. before bronchoscopy. There were two control groups: patients with hematological diagnoses not meeting definitions for proven or probable IPA and patients with nonhematological diagnoses with no evidence of aspergillosis. Following bronchoscopy and BAL, GM testing was performed using the Platelia Aspergillus seroassay in accordance with the manufacturer's instructions.RESULTS:There were 51 cases and 20 controls. Cases had higher BAL fluid GM OD indices (ODIs) (mean: 1.27 and range: 0.4–3.78) compared with controls (mean: 0.26 and range: 0.09–0.35). Receiver operating characteristic analysis demonstrated an optimum ODI cutoff of 1.0, with high specificity (100%) and sensitivity (87.5%) for diagnosing IPA.CONCLUSIONS:Our results support BAL GM testing as a reasonably safe test with higher sensitivity compared to serum GM testing in at-risk patients with hematological diseases. A higher OD cutoff is necessary to avoid overdiagnosis of IPA.

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Section: Discussionmentioning

confidence: 99%

Comparative evaluation of galactomannan test with bronchoalveolar lavage and serum for the diagnosis of invasive aspergillosis in patients with hematological malignancies

et al. 2017

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“…Only patients who received at least 3 days of antifungal therapy were selected to ensure the accuracy of the IPA diagnosis. This definition of IPA was applied in our previous study [ 3 ]. We defined patients who died during the hospitalization (in-hospital death) as the case group, and patients who were discharged from the hospital (survival) as the control group.…”

Section: Methodsmentioning

confidence: 99%

“…Most cases of IA have pulmonary involvement and often lead to severe pneumonia with respiratory failure requiring intubation and mechanical ventilation [ 1 , 2 ]. The incidence of invasive pulmonary aspergillosis (IPA) has been increasing over the years [ 3 ], and patients with pre-existing conditions such as end-stage renal disease (ESRD), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and long-term steroid use are more susceptible than previously suspected [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome and prognostic factors associated with invasive pulmonary aspergillosis: An 11-year follow-up report from Taiwan

et al. 2017

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BackgroundInvasive pulmonary aspergillosis (IPA) has high mortality rate but prognostic factors are not well established. The aim of our study was to evaluate the trend in in-hospital mortality over a period of 11 years and identify factors affecting the clinical outcomes of patients with IPA.MethodWe conducted a nationwide inpatient population study using data from the Taiwan National Health Insurance Research Database. A total of 407 IPA patients from 2002 to 2012 were included in the study. Differences in demographics, comorbidities, and treatment were evaluated between in-hospital death group and survival group. Multivariate analysis was also performed to identify risk factors for mortality.ResultMale patients represented 63.14% of the patients (n = 257) and the mean age was 53.15 ± 20.93 years. Hematological cancer (n = 216, 53.07%) and diabetes mellitus (n = 75, 18.43%) were the most common underlying conditions. The overall case fatality rate was 30.22% with female slightly higher then male (32.67% versus 28.79%). The in-hospital case fatality rate increased since 2002 and peaked in 2006. It then declined over time with an in-hospital mortality of 25% in 2012. The in-hospital death group had a higher intubation rate (p<0.0001), a longer ICU stay (p = 0.0062), higher percentages of DM (p = 0.0412) and COPD (p = 0.0178), and a lower percentage of hematological cancer (p = 0.0079) as compared to survivor. The in-hospital death group was more likely to have steroid treatment (p<0.0001), develop acute renal failure (p<0.0001) and other infectious diseases (p = 0.0008) during hospitalization. Multivariate analysis identified female gender, older age (≥ 65 years old), intubation, bone marrow transplantation, acute renal failure, other infectious diseases and steroid use as predictive factors for mortality.ConclusionThe present study shows the trend in mortality among patients with IPA over an 11-year period. Female gender, older age, intubation, bone marrow transplantation, acute renal failure, other infectious diseases and steroid use were identified as risk factors for mortality.

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“…These fungi cause life-threatening diseases mainly affecting immunocompromised patients with underlying hematological disease, cancer, autoimmune diseases, as well as solid organ transplant (SOT) recipients or critically ill patients, including those with respiratory viral infections [4,5]. The increasing number of patients at risk is accompanied by rising frequencies of fungal infections due to Aspergillus spp, as well as the more frequent affection of male patients [6][7][8][9]. Prevalence can significantly vary among geographic regions, different centers and patient populations [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Invasive Aspergillosis: How It’s Going, Where It’s Heading

et al. 2023

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Despite improvements in treatment and diagnostics over the last two decades, invasive aspergillosis (IA) remains a devastating fungal disease. The number of immunocompromised patients and hence vulnerable hosts increases, which is paralleled by the emergence of a rise in IA cases. Increased frequencies of azole-resistant strains are reported from six continents, presenting a new challenge for the therapeutic management. Treatment options for IA currently consist of three classes of antifungals (azoles, polyenes, echinocandins) with distinctive advantages and shortcomings. Especially in settings of difficult to treat IA, comprising drug tolerance/resistance, limiting drug–drug interactions, and/or severe underlying organ dysfunction, novel approaches are urgently needed. Promising new drugs for the treatment of IA are in late-stage clinical development, including olorofim (a dihydroorotate dehydrogenase inhibitor), fosmanogepix (a Gwt1 enzyme inhibitor), ibrexafungerp (a triterpenoid), opelconazole (an azole optimized for inhalation) and rezafungin (an echinocandin with long half-life time). Further, new insights in the pathophysiology of IA yielding immunotherapy as a potential add-on therapy. Current investigations show encouraging results, so far mostly in preclinical settings. In this review we discuss current treatment strategies, give an outlook on possible new pharmaceutical therapeutic options, and, lastly, provide an overview of the ongoing research in immunotherapy for IA.

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Correction: Galactomannan Testing and the Incidence of Invasive Pulmonary Aspergillosis: A 10-Year Nationwide Population-Based Study in Taiwan

Abstract: There is an error within Table 3. The country in Row 4 is incorrectly labeled as 'Australia'. The correct country should be: Austria. Please see the corrected Table 3 here.

Cited by 5 publications

References 1 publication

Comparative evaluation of galactomannan test with bronchoalveolar lavage and serum for the diagnosis of invasive aspergillosis in patients with hematological malignancies

Comparative evaluation of galactomannan test with bronchoalveolar lavage and serum for the diagnosis of invasive aspergillosis in patients with hematological malignancies

Clinical outcome and prognostic factors associated with invasive pulmonary aspergillosis: An 11-year follow-up report from Taiwan

Treatment of Invasive Aspergillosis: How It’s Going, Where It’s Heading

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