Factors affecting mortality in COVID-19-associated pulmonary aspergillosis: An international ID-IRI study DOI Creative Commons
Meyha Şahin, Mesut Yılmaz, Ali Mert

et al.

Heliyon, Journal Year: 2024, Volume and Issue: 10(14), P. e34325 - e34325

Published: July 1, 2024

BackgroundThis study aimed to identify factors that influence the mortality rate of patients with coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA).MethodsIn this cross-sectional study, data from 23 centers across 15 countries, spanning period March 2020 December 2021, were retrospectively collected. The population comprised who developed invasive while being treated for COVID-19 in intensive care unit. Cox regression and decision tree analyses used associated CAPA.ResultsA total 162 (males, 65.4 %; median age: 64 [25th–75th: 54.0–73.8] years) included whom 113 died during 90-day follow-up period. duration CAPA diagnosis death was 12 (25th–75th: 7–19) days. In multivariable model, an age ≥65 years (hazard ratio [HR]: 2.05, 95 % confidence interval [CI]: 1.37–3.07), requiring vasopressor therapy at time (HR: 1.80, CI: 1.17–2.76), receiving renal replacement 2.27, 1.35–3.82) identified as predictors mortality. Decision analysis revealed aged received corticosteroid treatment displayed higher rates (estimated rate: 1.6, observed 46 patients).ConclusionThis concluded elderly receive corticosteroids are a significantly risk mortality, particularly if they experience multiorgan failure.

Language: Английский

Modeling Invasive Aspergillosis Risk for the Application of Prophylaxis Strategies DOI Creative Commons
Jo‐Anne H. Young, David R. Andes, Monica I. Ardura

et al.

Open Forum Infectious Diseases, Journal Year: 2024, Volume and Issue: 11(3)

Published: Feb. 6, 2024

Abstract The epidemiology of invasive aspergillosis (IA) is evolving. To define the patient groups who will most likely benefit from primary or secondary Aspergillus prophylaxis, particularly those whose medical conditions and IA risk change over time, it helpful to depict populations their periods in a temporal visual model. Sankey approach provides dynamic figure understand for various populations. While depicted within this article static, an internet-based version could provide pop-up highlights any given flow's origin destination nodes. A future highlight links publications that support color-coded incidence rates other actionable items, such as bundles applicable pharmacologic non-pharmacologic interventions. figure, part upcoming Infectious Diseases Society America's clinical practice guidelines, can guide decision-making settings.

Language: Английский

Citations

9
Risk factors for COVID-19 associated pulmonary aspergillosis and outcomes in patients with acute respiratory failure in a respiratory sub-intensive care unit DOI Creative Commons
Alessandra Iacovelli, Alessandra Oliva,

Flavio Marco Mirabelli

et al.

BMC Infectious Diseases, Journal Year: 2024, Volume and Issue: 24(1)

Published: April 11, 2024

Abstract Background COVID-19-associated pulmonary aspergillosis (CAPA) is burdened by high mortality. Data are lacking about non-ICU patients. Aims of this study were to: (i) assess the incidence and prevalence CAPA in a respiratory sub-intensive care unit, (ii) evaluate its risk factors (iii) impact on in-hospital Secondary aims associated to mortality, significant features hematological Materials methods This was single-center, retrospective COVID-19 patients with acute failure. A cohort compared non-CAPA cohort. Among CAPA, further another non-hematological Results Three hundred fifty included study. Median P/F ratio at admission unit 225 mmHg (IQR 155–314). 55 (15.7%) developed (incidence 5.5%). Eighteen had probable (37.3%), 37 (67.3%) possible none proven CAPA. Diagnosis occurred median 17 days 12–31) from SARS-CoV-2 infection. Independent for malignancy [OR 1.74 (95%CI 0.75–4.37), p = 0.0003], lymphocytopenia 2.29 1.12–4.86), 0.02], COPD 2.74 1.19–5.08), 0.014]. Mortality rate higher (61.8% vs 22.7%, < 0.0001). resulted an independent factor mortality 2.92 1.47–5.89), 0.0024]. patients, age > 65 years predictor 5.09 (95% CI 1.20–26.92), 0.035]. No differences observed Conclusion life-threatening condition rates. It should be promptly suspected, especially case malignancy, lymphocytopenia.

Language: Английский

Citations

6
Gut-Derived Short-Chain Fatty Acids and Macrophage Modulation: Exploring Therapeutic Potentials in Pulmonary Fungal Infections DOI
Qian Xie, Qinhui Li, Hong Fang

et al.

Clinical Reviews in Allergy & Immunology, Journal Year: 2024, Volume and Issue: 66(3), P. 316 - 327

Published: July 5, 2024

Language: Английский

Citations

5
Pharmacokinetics of isavuconazole at different target sites in healthy volunteers after single and multiple intravenous infusions DOI Creative Commons
Felix Bergmann,

Michael Wölfl‐Duchek,

Anselm Jorda

et al.

Journal of Antimicrobial Chemotherapy, Journal Year: 2024, Volume and Issue: 79(5), P. 1169 - 1175

Published: March 28, 2024

Abstract Background Invasive aspergillosis is a severe fungal infection that affects multiple organ systems including the CNS and lungs. Isavuconazole, novel triazole antifungal agent, has demonstrated promising activity against Aspergillus spp. However, data on penetration of isavuconazole into ELF intracellular accumulation remain limited. Materials methods We conducted prospective single-centre pharmacokinetic (PK) study in 12 healthy volunteers. Subjects received seven doses 200 mg to achieve an assumed steady-state. After first final infusion, plasma sampling was over 8 h, respectively. All subjects underwent one lumbar puncture bronchoalveolar lavage, at either 2, 6 or h post-infusion dose. PBMCs were collected six from blood determine concentrations 6, h. The AUC/MIC calculated for MIC value 1 mg/L, which marks EUCAST susceptibility breakpoint fumigatus flavus. Results C max AUC0-24h under steady-state conditions 6.57 ± 1.68 mg/L (mean SD) 106 32.1 h·mg/L, average measured CSF, 0.07 0.03, 0.94 0.46 27.1 17.8 plasma, 32.1, 0.72, 22.6 11.0 650 426 mg·h/L, Conclusion Isavuconazole moderate ELF, low penetrability CSF high PBMCs. Current dosing regimens resulted sufficient exposure all treat isolates with MICs ≤ mg/L.

Language: Английский

Citations

4
Aspergillosis in Critically Ill Patients with and Without COVID-19 in a Tertiary Hospital in Southern Brazil DOI
Mariana Rodrigues Trápaga, Vanice Rodrigues Poester, Rossana Patrícia Basso

et al.

Mycopathologia, Journal Year: 2024, Volume and Issue: 189(3)

Published: June 1, 2024

Language: Английский

Citations

4
Aspergillus Contamination in Healthcare Facilities: An Ever-Present Issue—Prevention and Control Measures DOI Creative Commons
Anna Maria Spagnolo

Hygiene, Journal Year: 2025, Volume and Issue: 5(1), P. 3 - 3

Published: Jan. 22, 2025

Aspergillus spp. are ubiquitous fungi present in soil, organic debris, water, decaying vegetation and dust produced renovation and/or building work. Several studies have shown the presence of aspergilli various healthcare environments. Typically, thousands fungal spores inhaled every day, but if spore clearance fails (typically immunocompromised patients), can grow invade lung tissue, causing invasive aspergillosis (IA) which is one most frequent infections highly patients. fumigatus common species involved; this be attributed to about 80% cases aspergillosis. According WHO, four critical priority fungi. The first-line treatment diseases caused by Aspergillus, particular IA, based on triazole antimycotics. Unfortunately, resistance antimycotics increasing, partly due their widespread use areas, becoming a significant concern clinicians who charged with caring for patients at high risk mycoses. A recent WHO report emphasised need strategies improve response, strengthen laboratory capacity surveillance, support investment research public health interventions prevention control through One Health approach.

Language: Английский

Citations

0
Machine Learning Methods Based on Chest CT for Predicting the Risk of COVID-19-Associated Pulmonary Aspergillosis DOI
Jiahao Liu, Juntao Zhang, Huaizhen Wang

et al.

Academic Radiology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

Citations

0
Key fungal coinfections: epidemiology, mechanisms of pathogenesis, and beyond DOI Creative Commons
Danielle L. da Silva,

Nalu T. A. Peres,

Daniel Assis Santos

et al.

mBio, Journal Year: 2025, Volume and Issue: unknown

Published: April 2, 2025

Coinfection is defined as the occurrence of at least two genetically distinct infectious agents within same host. Historically, fungal infections have been neglected, leading to an underestimation their impact on public health systems. However, coinfections become increasingly prevalent, emerging a significant global concern. This review explores commonly associated with HIV, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza, Mycobacterium tuberculosis, and Pseudomonas species. These include candidiasis, aspergillosis, paracoccidioidomycosis, cryptococcosis, histoplasmosis, pneumocystosis, sporotrichosis, mucormycosis. We discuss key local systemic mechanisms that contribute these coinfections. HIV infects CD4+ cells, causing immunosuppression, particularly impairing adaptive immune response. The inflammatory response SARS-CoV-2 infection disrupts both pulmonary homeostasis, rendering individuals more vulnerable disseminated Severe influenza promotes by triggering production pro-inflammatory cytokines, which damage epithelial-endothelial barrier impair recognition phagocytosis cells. Tuberculosis can replace normal lung parenchyma collagen tissue, alterations in architecture, compromising its function. Interaction between Aspergillus during coinfection involves competition for iron availability deprivation. Therefore, specific interactions each underlying disease are detailed this review. In addition, we highlight risk factors coinfections, pathophysiology, epidemiology, challenges early diagnosis. Recognizing substantial worldwide burden posed crucial improve survival rates.

Language: Английский

Citations

0
Factors affecting mortality in COVID-19-associated pulmonary aspergillosis: An international ID-IRI study DOI Creative Commons
Meyha Şahin, Mesut Yılmaz, Ali Mert

et al.

Heliyon, Journal Year: 2024, Volume and Issue: 10(14), P. e34325 - e34325

Published: July 1, 2024

BackgroundThis study aimed to identify factors that influence the mortality rate of patients with coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA).MethodsIn this cross-sectional study, data from 23 centers across 15 countries, spanning period March 2020 December 2021, were retrospectively collected. The population comprised who developed invasive while being treated for COVID-19 in intensive care unit. Cox regression and decision tree analyses used associated CAPA.ResultsA total 162 (males, 65.4 %; median age: 64 [25th–75th: 54.0–73.8] years) included whom 113 died during 90-day follow-up period. duration CAPA diagnosis death was 12 (25th–75th: 7–19) days. In multivariable model, an age ≥65 years (hazard ratio [HR]: 2.05, 95 % confidence interval [CI]: 1.37–3.07), requiring vasopressor therapy at time (HR: 1.80, CI: 1.17–2.76), receiving renal replacement 2.27, 1.35–3.82) identified as predictors mortality. Decision analysis revealed aged received corticosteroid treatment displayed higher rates (estimated rate: 1.6, observed 46 patients).ConclusionThis concluded elderly receive corticosteroids are a significantly risk mortality, particularly if they experience multiorgan failure.

Language: Английский

Citations

0