Invasive aspergillosis in the intensive care unit

Meersseman, W.; Lagrou, K.; Maertens, J.; Wijngaerden, E. V.

doi:10.1086/518852

Cited by 366Antifungal resistance and susceptibilityNosocomial Infections in ICUFungal Infections and Studies

Invasive aspergillosis in the intensive care unit

Meersseman, W., Lagrou, K., Maertens, J., Wijngaerden, E. V.·2007·Clinical Infectious Diseases

DOI 10.1086/518852

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Abstract

Data regarding the incidence of invasive aspergillosis (IA) in the intensive care unit (ICU) are scarce, and the incidence varies. An incidence of 5.8% in a medical ICU has been reported. The majority of patients did not have a hematological malignancy, and conditions such as chronic obstructive pulmonary disease and liver failure became recognized as risk factors. Diagnosis of IA remains difficult. Mechanical ventilation makes it difficult to interpret clinical signs, and radiological diagnoses are clouded by underlying lung pathologies. The significance of a positive respiratory culture result is greatly uncertain, because cultures of respiratory specimens have low sensitivity (50%) and specificity (20%-70%, depending on whether the patient is immunocompromised). The use of serologic markers has never been validated in an ICU population. Limited experience with the detection of galactomannan in bronchoalveolar lavage fluid specimens has yielded promising results. Because of a delay in the diagnosis of IA, the mortality rate exceeds 50%. Recently, our therapeutic armamentarium against IA has improved. Data concerning the safety and efficacy of new antifungal agents in the ICU setting, however, are lacking.

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Authors: Meersseman, W., Lagrou, K., Maertens, J., & Wijngaerden, E. V.
Affiliations: Universitair Ziekenhuis Leuven (BE)
KU Leuven (BE)
Corresponding author: Meersseman, W.
ORCID: Meersseman, W.
Maertens, J.
Wijngaerden, E. V.
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2007-07-15
Volume: 45
Issue: 2
Pages: 205-216
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1086/518852
OpenAlex: W2140505203
Cited by: 366
References: 81
Citations by year: 2026: 8 · 2025: 19 · 2024: 9 · 2023: 17 · 2022: 15 · 2021: 28 · 2020: 16 · 2019: 16 · 2018: 20 · 2017: 18 · 2016: 21 · 2015: 18 · 2014: 18 · 2013: 28 · 2012: 21
FWCI: 2.57
Type: journal article
Language: en
Open access: closed
Locations: Clinical Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
Funders: Pfizer
Gilead Sciences
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords: invasive aspergillosis, intensive care unit, incidence, risk factors, chronic obstructive pulmonary disease, liver failure, mechanical ventilation, serological markers, galactomannan, bronchoalveolar lavage, mortality, antifungal therapy, immunocompromised patients
MeSH terms: Antifungal Agents, Aspergillosis, Cross Infection, Female, Humans, Intensive Care Units, Lung Diseases, Fungal, Male, Prognosis, Severity of Illness Index, Incidence, Survival Analysis, Fungemia, Infection Control, Risk Assessment

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Invasive aspergillosis in the intensive care unit

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