Invasive aspergillosis in critically ill patients without malignancy
Abstract
Using criteria designed for invasive aspergillosis (IA) in patients with cancer, we aimed to determine the impact of IA in patients without malignancy in a medical intensive care unit (ICU). In this retrospective study, 127 patients out of 1,850 admissions (6.9%) hospitalized between 2000 and 2003 had microbiological or histopathologic evidence of Aspergillus during their ICU stay. There were 89 cases (70%) without hematologic malignancy. These patients were classified as proven IA (n = 30), probable IA (n = 37), possible IA (n = 2), or colonization (n = 20). In these patients, mean SAPS II score was 52 with a predicted mortality of 48%. The observed mortality was 80% (n = 71). Mortality of the proven and the probable IA was 97 and 87%, respectively. Postmortem examination was done in 46 out of 71 patients, and 27 autopsies (59%) showed hyphael invasion with Aspergillus. Aspergillus infections occurred in five critically ill patients with proven IA who did not have any predisposing factors according to the currently available definitions. Three of these patients had Child C liver cirrhosis. IA is an emerging and devastating infectious disease in patients in the ICU without malignancy. In those patients, host criteria for probable fungal infections should probably be adapted.
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With increasingly immunocompromised patient populations, other fungal species such as Aspergillus, Pneumocystis jiroveci, Cryptococcus, Zygomycetes, Fusarium, and Scedosporium have emerged.
“With increasingly immunocompromised patient populations, other fungal species such as Aspergillus species, Pneumocystis jiroveci, Cryptococcus, Zygomycetes, Fusarium species, and Scedosporium species have emerged.[4][5][6][7][8][9]”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [6]
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BackgroundMethodInfluentialGenomic Diversity of Azole-Resistant Aspergillus fumigatus in the United States
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- Authors
- Meersseman, W., Vandecasteele, S. J., Wilmer, A., Verbeken, E., Peetermans, W. E., & Van Wijngaerden, E.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- Medical Intensive Care Unit and Infectious Diseases Unit, Department of General Internal Medicine; and Department of Pathology, University Hospital, Leuven, Belgium
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-09
- Volume
- 170
- Issue
- 6
- Pages
- 621-625
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2108396393
- Cited by
- 547
- References
- 23
- Citations by year
- 2026: 11 · 2025: 25 · 2024: 18 · 2023: 18 · 2022: 16 · 2021: 32 · 2020: 22 · 2019: 24 · 2018: 18 · 2017: 28 · 2016: 25 · 2015: 23 · 2014: 34 · 2013: 35 · 2012: 34
- FWCI
- 14.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- 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 › Oncology › Neutropenia and Cancer Infections
- Keywords
- invasive aspergillosis, critically ill patients, intensive care unit, Aspergillus, mortality, liver cirrhosis, autopsy findings, fungal infection diagnosis, SAPS II
- MeSH terms
- Aged, Aspergillosis, Belgium, Female, Humans, Intensive Care Units, Liver Cirrhosis, Male, Middle Aged, Neoplasms, Retrospective Studies, Risk Factors, Cohort Studies, Critical Illness
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