ArticlePloS one2013
Composite survival index to compare virulence changes in azole-resistant Aspergillus fumigatus clinical isolates.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed.
- Global epidemiology of azole resistance inJAC-antimicrobial resistance · 2026Review
- Triazole resistance inApplied and environmental microbiology · 2024Article
- Article
- Article
- Assessing Differences between Clinical Isolates ofPathogens (Basel, Switzerland) · 2022Article
- Phylogenetic Distribution ofMicrobiology spectrum · 2021Article
- Mechanisms of triazole resistance in Aspergillus fumigatus.Environmental microbiology · 2020Review
- The negative cofactor 2 complex is a key regulator of drug resistance in Aspergillus fumigatus.Nature communications · 2020Article
- Detection of TRAntimicrobial agents and chemotherapy · 2018Article
- Challenges in microbiological diagnosis of invasiveF1000Research · 2017Review
- Clinical implications of globally emerging azole resistance in Aspergillus fumigatus.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2016Review
- Azole Resistance in Aspergillus fumigatus: Can We Retain the Clinical Use of Mold-Active Antifungal Azoles?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Review
- Fitness Studies of Azole-Resistant Strains of Aspergillus fumigatus.Antimicrobial agents and chemotherapy · 2015Article
- Posaconazole prophylaxis in experimental azole-resistant invasive pulmonary aspergillosis.Antimicrobial agents and chemotherapy · 2015Article
- The strength of synergistic interaction between posaconazole and caspofungin depends on the underlying azole resistance mechanism of Aspergillus fumigatus.Antimicrobial agents and chemotherapy · 2015Article
- Emergence of azole-resistant aspergillus fumigatus strains due to agricultural azole use creates an increasing threat to human health.PLoS pathogens · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Understanding resistance to antifungal agents in Aspergillus fumigatus is of increasing importance for the treatment of invasive infections in immunocompromised patients. Although a number of molecular resistance mechanisms are described in detail, the potential accompanying virulence changes and impact on clinical outcome have had little attention. We developed a new measure of survival, the composite survival index (CSI) to use as a measure of the virulence properties of A. fumigatus. Using a novel mathematical model we found a strong correlation between the in vitro growth characteristics and virulence in vivo expressed as CSI. Our model elucidates how three critical parameters (the lag phase (τ), decay constant (λ), and growth rate (ν)) interact with each other resulting in a CSI that correlated with virulence. Hence, strains with a long lag phase and high decay constant were less virulent in a murine model of invasive aspergillosis, whereas high virulence for isolates with a high CSI was associated in vitro with rapid growth and short lag phases. Resistant isolates with cyp51A mutations, which account for the majority of azole resistant aspergillosis cases, did not show a lower virulence compared to azole-susceptible isolates. In contrast, the CSI index revealed that a non-cyp51A-mediated resistance mechanism was associated with a dramatic decrease in CSI. Because of its predictive value, the mathematical model developed may serve to explore strain characteristics in vitro to predict virulence in vivo and significantly reduce the number of experimental animals required in such studies. The proposed measure of survival, the CSI can be used more in a general form in survival studies to explore optimal treatment options.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.