Influenza-associated invasive aspergillosis in patients admitted to the intensive care unit in Sweden : a prospective multicentre cohort study
BACKGROUND: The purpose of this study was to prospectively investigate the incidence of influenza-associated pulmonary aspergillosis (IAPA) in influenza patients admitted to intensive care units in Sweden.
METHODS: The study included consecutive adult patients with PCR-verified influenza A or B in 12 Swedish intensive care units (ICUs) over four influenza seasons (2019-2023). Patients were screened using serum galactomannan and β-d-glucan tests and fungal culture of a respiratory sample at inclusion and weekly during the ICU stay. Bronchoalveolar lavage was performed if clinically feasible. IAPA was classified according to recently proposed case definitions.
RESULTS: The cohort included 55 patients; 42% were female, and the median age was 59 (IQR 48-71) years. All patients had at least one galactomannan test, β-d-glucan test and respiratory culture performed. Bronchoalveolar lavage was performed in 24 (44%) of the patients. Five (9%, 95% CI 3.8% - 20.4%) patients were classified as probable IAPA, of which four lacked classical risk factors. The overall ICU mortality was significantly higher among IAPA patients than non-IAPA patients (60% vs 8%, p = 0.01).
CONCLUSIONS: The study represents the first prospective investigation of IAPA incidence. The 9% incidence of IAPA confirms the increased risk of invasive pulmonary aspergillosis among influenza patients admitted to the ICU. Therefore, it appears reasonable to implement a screening protocol for the early diagnosis and treatment of IAPA in influenza patients receiving intensive care.
TRIAL REGISTRATION: ClinicalTrials.gov NCT04172610, registered November 21, 2019.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
|---|---|
| Enthalten in: |
Infectious diseases (London, England) - 56(2024), 2 vom: 15. Jan., Seite 110-115 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Krifors, Anders [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Clinical Study |
|---|
| Anmerkungen: |
Date Completed 11.01.2024 Date Revised 11.01.2024 published: Print-Electronic ClinicalTrials.gov: NCT04172610 Citation Status MEDLINE |
|---|
| doi: |
10.1080/23744235.2023.2273381 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM363898115 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM363898115 | ||
| 003 | DE-627 | ||
| 005 | 20240114233805.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1080/23744235.2023.2273381 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1256.xml |
| 035 | |a (DE-627)NLM363898115 | ||
| 035 | |a (NLM)37897800 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Krifors, Anders |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Influenza-associated invasive aspergillosis in patients admitted to the intensive care unit in Sweden |b a prospective multicentre cohort study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 11.01.2024 | ||
| 500 | |a Date Revised 11.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04172610 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The purpose of this study was to prospectively investigate the incidence of influenza-associated pulmonary aspergillosis (IAPA) in influenza patients admitted to intensive care units in Sweden | ||
| 520 | |a METHODS: The study included consecutive adult patients with PCR-verified influenza A or B in 12 Swedish intensive care units (ICUs) over four influenza seasons (2019-2023). Patients were screened using serum galactomannan and β-d-glucan tests and fungal culture of a respiratory sample at inclusion and weekly during the ICU stay. Bronchoalveolar lavage was performed if clinically feasible. IAPA was classified according to recently proposed case definitions | ||
| 520 | |a RESULTS: The cohort included 55 patients; 42% were female, and the median age was 59 (IQR 48-71) years. All patients had at least one galactomannan test, β-d-glucan test and respiratory culture performed. Bronchoalveolar lavage was performed in 24 (44%) of the patients. Five (9%, 95% CI 3.8% - 20.4%) patients were classified as probable IAPA, of which four lacked classical risk factors. The overall ICU mortality was significantly higher among IAPA patients than non-IAPA patients (60% vs 8%, p = 0.01) | ||
| 520 | |a CONCLUSIONS: The study represents the first prospective investigation of IAPA incidence. The 9% incidence of IAPA confirms the increased risk of invasive pulmonary aspergillosis among influenza patients admitted to the ICU. Therefore, it appears reasonable to implement a screening protocol for the early diagnosis and treatment of IAPA in influenza patients receiving intensive care | ||
| 520 | |a TRIAL REGISTRATION: ClinicalTrials.gov NCT04172610, registered November 21, 2019 | ||
| 650 | 4 | |a Clinical Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Influenza | |
| 650 | 4 | |a influenza-associated aspergillosis | |
| 650 | 4 | |a intensive care medicine | |
| 650 | 4 | |a invasive aspergillosis | |
| 650 | 7 | |a Glucans |2 NLM | |
| 700 | 1 | |a Blennow, Ola |e verfasserin |4 aut | |
| 700 | 1 | |a Påhlman, Lisa I |e verfasserin |4 aut | |
| 700 | 1 | |a Gille-Johnson, Patrik |e verfasserin |4 aut | |
| 700 | 1 | |a Janols, Helena |e verfasserin |4 aut | |
| 700 | 1 | |a Lipcsey, Miklos |e verfasserin |4 aut | |
| 700 | 1 | |a Källman, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Tham, Johan |e verfasserin |4 aut | |
| 700 | 1 | |a Stjärne Aspelund, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Ljungquist, Oskar |e verfasserin |4 aut | |
| 700 | 1 | |a Hammarskjöld, Fredrik |e verfasserin |4 aut | |
| 700 | 1 | |a Hällgren, Anita |e verfasserin |4 aut | |
| 700 | 1 | |a De Geer, Lina |e verfasserin |4 aut | |
| 700 | 1 | |a Lemberg, Marie |e verfasserin |4 aut | |
| 700 | 1 | |a Petersson, Johan |e verfasserin |4 aut | |
| 700 | 1 | |a Castegren, Markus |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Infectious diseases (London, England) |d 2015 |g 56(2024), 2 vom: 15. Jan., Seite 110-115 |w (DE-627)NLM242918921 |x 2374-4243 |7 nnns |
| 773 | 1 | 8 | |g volume:56 |g year:2024 |g number:2 |g day:15 |g month:01 |g pages:110-115 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1080/23744235.2023.2273381 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 56 |j 2024 |e 2 |b 15 |c 01 |h 110-115 | ||