Invasive pulmonary aspergillosis in the intensive care unit: current challenges and best practices

Gaffney, Sarah; Kelly, Dearbhla M.; Rameli, Puteri Maisarah; Kelleher, Eoin; Martín‐Loeches, Ignacio

doi:10.1111/apm.13316

Cited by 2 publications

(2 citation statements)

References 81 publications

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“…As a consequence, CAPA diagnosis relies heavily on mycological criteria, 100 possibly overdiagnosing CAPA in colonized patients. 142 A later taskforce report removed the possibility of using NBLF and positioned bronchoscopy with BALF as a cornerstone of CAPA diagnosis. 102 This strategy erases the "possible CAPA" label and should increase specificity.…”

Section: Capa: Ecmm/isham Capa Consensus Criteria Followed By the Tas...mentioning

confidence: 99%

Acute Invasive Pulmonary Aspergillosis: Clinical Presentation and Treatment

Heylen,

Vanbiervliet,

Maertens

et al. 2024

Semin Respir Crit Care Med

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Among all clinical manifestations of pulmonary aspergillosis, invasive pulmonary aspergillosis (IPA) is the most acute presentation. IPA is caused by Aspergillus hyphae invading the pulmonary tissue, causing either tracheobronchitis and/or bronchopneumonia. The degree of fungal invasion into the respiratory tissue can be seen as a spectrum, going from colonization to deep tissue penetration with angio-invasion, and largely depends on the host's immune status. Patients with prolonged, severe neutropenia and patients with graft-versus-host disease are at particularly high risk. However, IPA also occurs in other groups of immunocompromised and nonimmunocompromised patients, like solid organ transplant recipients or critically ill patients with severe viral disease. While a diagnosis of proven IPA is challenging and often warranted by safety and feasibility, physicians must rely on a combination of clinical, radiological, and mycological features to assess the likelihood for the presence of IPA. Triazoles are the first-choice regimen, and the choice of the drug should be made on an individual basis. Adjunctive therapy such as immunomodulatory treatment should also be taken into account. Despite an improving and evolving diagnostic and therapeutic armamentarium, the burden and mortality of IPA still remains high. This review aims to give a comprehensive and didactic overview of the current knowledge and best practices regarding the epidemiology, clinical presentation, diagnosis, and treatment of acute IPA.

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Section: Capa: Ecmm/isham Capa Consensus Criteria Followed By the Tas...mentioning

confidence: 99%

Acute Invasive Pulmonary Aspergillosis: Clinical Presentation and Treatment

Heylen,

Vanbiervliet,

Maertens

et al. 2024

Semin Respir Crit Care Med

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“…This is due to the limitations of the current diagnostic methods. Moreover, until recently clinicians had limited access to anti-fungal susceptibility testing [ 16 ]. Since the severity of the Aspergillus -related diseases depends on the Aspergillus strain, it is pivotal to identify the stain and the right anti-fungal treatment for each case [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

A Multiplex PCR Melting-Curve-Analysis-Based Detection Method for the Discrimination of Five Aspergillus Species

Tokamani,

Figgou,

Papamichail

et al. 2023

JoF

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Aspergillus mold is a ubiquitously found, airborne pathogen that can cause a variety of diseases from mild to life-threatening in severity. Limitations in diagnostic methods combined with anti-fungal resistance render Aspergillus a global emerging pathogen. In industry, Aspergilli produce toxins, such as aflatoxins, which can cause food spoilage and pose public health risk issues. Here, we report a multiplex qPCR method for the detection and identification of the five most common pathogenic Aspergillus species, Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Aspergillus terreus, and Aspergillus nidulans. Our approach exploits species-specific nucleotide polymorphisms within their ITS genomic regions. This novel assay combines multiplex single-color real time qPCR and melting curve analysis and provides a straight-forward, rapid, and cost-effective detection method that can identify five Aspergillus species simultaneously in a single reaction using only six unlabeled primers. Due to their unique fragment lengths, the resulting amplicons are directly linked to certain Aspergillus species like fingerprints, following either electrophoresis or melting curve analysis. Our method is characterized by high analytical sensitivity and specificity, so it may serve as a useful and inexpensive tool for Aspergillus diagnostic applications both in health care and the food industry.

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Invasive pulmonary aspergillosis in the intensive care unit: current challenges and best practices

Cited by 2 publications

References 81 publications

Acute Invasive Pulmonary Aspergillosis: Clinical Presentation and Treatment

Acute Invasive Pulmonary Aspergillosis: Clinical Presentation and Treatment

A Multiplex PCR Melting-Curve-Analysis-Based Detection Method for the Discrimination of Five Aspergillus Species

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