ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Performance of Diagnostic Algorithms in Patients With Invasive Pulmonary Aspergillosis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- Unclassifiable Invasive Pulmonary Aspergillosis in the Intensive Care Unit: Insights From a Multicenter, Retrospective Cohort Study in France (2022-2024).Open forum infectious diseases · 2026Article
- Population pharmacokinetics, target attainment and individualized dosing of isavuconazole in critically ill adults receiving extracorporeal membrane oxygenation.JAC-antimicrobial resistance · 2026Article
- Relationship between negative-pressure ICU rooms and the risk of COVID-19-associated pulmonary aspergillosis: an ancillary analysis of the COVID-ICU cohort study.Critical care (London, England) · 2026Article
- Aspergillosis: An Update on Epidemiology, Risk Factors, Diagnosis, Susceptibility, and Treatment.Journal of fungi (Basel, Switzerland) · 2026Review
- Empirical Antifungal Treatment of Critically Ⅲ Patients With Influenza-Associated Acute Respiratory Distress Syndrome: A Propensity Score Weighted Observational Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Observational
- Functional and molecular characterization ofJournal of medical microbiology · 2026Article
- Development and Internal Validation of a Nomogram Model to Predict Invasive Pulmonary Aspergillosis Occurrence Risk in ICU Patients with Sepsis.Infection and drug resistance · 2026Article
- Review
- Unmasking Invasive Pulmonary Aspergillosis: Insights From a Case Series at a Tertiary Care Center.Cureus · 2025Article
- Lateral Flow DeviceOpen forum infectious diseases · 2025Article
- Validation of the "invasive pulmonary aspergillosis in immunocompromised patients with acute respiratory failure score" (IPA-GRRR-OH score).Intensive care medicine · 2025Article
- Comparison of Patients With or Without COVID-19 and Without Hematological Diseases Treated for Invasive Pulmonary Aspergillosis: A 5-Year Retrospective Cohort Study with Propensity-Based Adjustment.Open forum infectious diseases · 2025Article
- Invasive pulmonary aspergillosis in the post-COVID-19 era: diagnosis, treatment, and what lies ahead.Therapeutic advances in infectious diseaseReview
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14 authors.
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Abstract
backgroundInvasive pulmonary aspergillosis (IPA), once limited to immunocompromised patients, is now a severe complication in critically ill ICU patients without classic risk factors. Due to the difficulty of obtaining histological evidence, diagnosis relies on poorly tested algorithms in real-world settings.
methodsWe conducted a retrospective multicenter (n = 9) cohort study including 202 patients with IPA. Patients were classified using a multistep process based on the EuropeanOrganization- for-the-Research-and-Treatment-of-Cancer/Mycosis-Study Group (EORTC-MSG), Invasive-Fungal-Diseases-in-Adult-Patients-in-Intensive-Care-Unit (FUNDICU), Aspergillus-ICU (Asp-ICU), and Asp-ICU with biomarkers (Asp-ICU-BM) criteria. We then evaluated the predictive performance of these criteria against the clinical cohort and histologically proven cases.
resultsAmong 202 patients, 78 had EORTC-MSG host factors and were classified accordingly, with EORTC-MSG criteria achieving 100% agreement in identifying clinical and histologically proven cases. In 112 ICU patients without EORTC-MSG host factors, overall agreement was 53% for FUNDICU, 4% for Asp-ICU, and 26% for Asp-ICU-BM versus the clinical cohort. Validation against histologically proven cases showed FUNDICU had 44% sensitivity and 75% specificity, Asp-ICU 6% sensitivity and 100% specificity, and Asp-ICU-BM 28% sensitivity and 63% specificity. Adding acute respiratory distress syndrome (ARDS) and post-cardiac surgery to the FUNDICU criteria improved sensitivity to 97% with a specificity of 63%. The remaining 12 patients lacked EORTC-MSG host factors and were not in the ICU, highlighting a novel classification system.
conclusionsEORTC-MSG and FUNDICU IPA classification systems are useful for the assignment of most patients with IPA. Incorporating postoperative complications after cardiac surgery and ARDS enhanced the diagnostic accuracy of FUNDICU.
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