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Taccone FS, Van den Abeele AM, Bulpa P, et al. Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes. Crit Care. 2015;19:7doi: 10.1186/s13054-014-0722-7.
Taccone, F. S., Van den Abeele, A. M., Bulpa, P., Misset, B., Meersseman, W., Cardoso, T., Paiva, J. A., Blasco-Navalpotro, M., De Laere, E., Dimopoulos, G., Rello, J., Vogelaers, D., Blot, S. I. (2015). Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes. Critical care (London, England), 197. https://doi.org/10.1186/s13054-014-0722-7
Taccone, Fabio Silvio, et al. "Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes." Critical care (London, England) vol. 19 (2015): 7. doi: https://doi.org/10.1186/s13054-014-0722-7
Taccone FS, Van den Abeele AM, Bulpa P, Misset B, Meersseman W, Cardoso T, Paiva JA, Blasco-Navalpotro M, De Laere E, Dimopoulos G, Rello J, Vogelaers D, Blot SI. Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes. Crit Care. 2015 Jan 12;19:7. doi: 10.1186/s13054-014-0722-7. PMID: 25928694; PMCID: PMC4344741.
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Crit Care. 2015 Jan 12;19:7. doi: 10.1186/s13054-014-0722-7.

Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes.

Critical care (London, England)

Fabio Silvio Taccone, Anne-Marie Van den Abeele, Pierre Bulpa, Benoit Misset, Wouter Meersseman, Teresa Cardoso, José-Artur Paiva, Miguel Blasco-Navalpotro, Emmanuel De Laere, George Dimopoulos, Jordi Rello, Dirk Vogelaers, Stijn I Blot,

Affiliations

  1. Department of Intensive Care Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070, Brussels, Belgium. [email protected].
  2. Department of Microbiology General Hospital St. Lucas, Groenebriel 1, 9000, Ghent, Belgium. [email protected].
  3. Department of Intensive Care Mont-Godinne University Hospital, Catholic University of Louvain, Avenue G.Thérasse 1, 5530, Yvoir, Belgium. [email protected].
  4. Department of Intensive Care Foundation Hospital Saint-Joseph, Paris-Descartes University, 185 Rue Raymond Losserand, 75014, Paris, France. [email protected].
  5. Medical Intensive Care Unit, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium. [email protected].
  6. Department of Intensive Care, Santo Antonio Hospital, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. [email protected].
  7. Department of Emergency and Intensive Care, Hospital Centre S. Joao and University of Porto Medical School Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. [email protected].
  8. Department of Intensive Care, University Hospital Severo Ochoa, Avenida de Orellana, s/n 28911, Leganés, Madrid, Spain. [email protected].
  9. Department of Microbiology, General Hospital Delta, Brugsesteenweg 90, 8800, Roeselare, Belgium. [email protected].
  10. Department of Critical Care Medicine, Attikon University Hospital, University of Athens Medical School, 1 Rimini Street, Haidari, 124 62, Athens, Greece. [email protected].
  11. Hospital Universitari Vall d'Hebron, Vall D'Hebron, Institute of Research, CIBERES, Autonomous University of Barcelona, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain. [email protected].
  12. Department of Internal Medicine Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. [email protected].
  13. Department of Internal Medicine Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. [email protected].
  14. Burns, Trauma, and Critical Care Research Centre, The University of Queensland, Butterfield Street, Herston (Brisbane), 4006, Queensland, Australia. [email protected].

PMID: 25928694 PMCID: PMC4344741 DOI: 10.1186/s13054-014-0722-7

Abstract

INTRODUCTION: Invasive aspergillosis (IA) is a fungal infection that particularly affects immunocompromised hosts. Recently, several studies have indicated a high incidence of IA in intensive care unit (ICU) patients. However, few data are available on the epidemiology and outcome of patients with IA in this setting.

METHODS: An observational study including all patients with a positive Aspergillus culture during ICU stay was performed in 30 ICUs in 8 countries. Cases were classified as proven IA, putative IA or Aspergillus colonization according to recently validated criteria. Demographic, microbiologic and diagnostic data were collected. Outcome was recorded 12 weeks after Aspergillus isolation.

RESULTS: A total of 563 patients were included, of whom 266 were colonized (47%), 203 had putative IA (36%) and 94 had proven IA (17%). The lung was the most frequent site of infection (94%), and Aspergillus fumigatus the most commonly isolated species (92%). Patients with IA had higher incidences of cancer and organ transplantation than those with colonization. Compared with other patients, they were more frequently diagnosed with sepsis on ICU admission and more frequently received vasopressors and renal replacement therapy (RRT) during the ICU stay. Mortality was 38% among colonized patients, 67% in those with putative IA and 79% in those with proven IA (P < 0.001). Independent risk factors for death among patients with IA included older age, history of bone marrow transplantation, and mechanical ventilation, RRT and higher Sequential Organ Failure Assessment score at diagnosis.

CONCLUSIONS: IA among critically ill patients is associated with high mortality. Patients diagnosed with proven or putative IA had greater severity of illness and more frequently needed organ support than those with Aspergillus spp colonization.

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