Observational studyAnnals of clinical microbiology and antimicrobials2025
Is neutropenia still the main risk factor for invasive aspergillosis? A contemporary university hospital retrospective cohort of invasive aspergillosis in neutropenic and non-neutropenic patients.
Observational study in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Isavuconazole for invasive mold disease in patients with hematological malignancies: a multicenter real-world study from China on efficacy, safety, and competing risks.Antimicrobial agents and chemotherapy · 2026Article
- Disseminated Invasive Aspergillosis in a Young Patient With Chronic Alcohol Use and Seemingly Preserved Immunocompetence: A Case Report.Clinical case reports · 2026Article
- Empiric antibiotic regimen for febrile neutropenia in cancer patients: a tertiary oncology center experience.Frontiers in oncology · 2026Article
- The clinical application of metagenomic next-generation sequencing for invasive pulmonary aspergillosis in neutropenic patients: a multicenter retrospective study in the ICU.Frontiers in cellular and infection microbiology · 2026Article
- Epidemiology, Risk Factors, and Routine Blood Biomarkers of Aspergillosis in Cancer Patients in Jiangxi, China.Infection and drug resistance · 2026Article
- Voriconazole-Induced Agranulocytosis in a Cirrhotic Patient with Influenza-Associated Pulmonary Aspergillosis: A Case Report.Infection and drug resistance · 2026Article
- Invasive Pulmonary Aspergillosis in Non-Neutropenic Patients: An Evolving Clinical Paradigm.Diagnostics (Basel, Switzerland) · 2025Review
- Invasive Sphenoid Sinus Aspergillosis in a Patient With Chronic Neutropenia: A Case Report.Cureus · 2025Article
- Subacute invasive pulmonary aspergillosis following breast cancer treatment: A one-year diagnostic odyssey.IDCases · 2025Article
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Authors and funding
18 authors.
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Abstract
introductionIn times of mold active prophylaxis, invasive aspergillosis (IA) epidemiology is evolving. Presentation in non-neutropenic may differ from neutropenic. We investigated the cases of IA in our center with a focus on differences between neutropenic and non-neutropenic, and analyzed the impact of cryptic and non-fumigatus Aspergillus species.
methodsRetrospective observational study including all adult patients admitted to the Puerta de Hierro-Majadahonda Hospital between January 2018 and April 2024 with IA.
results112 IA were identified. Only 11 (9.8%) had neutropenia as risk factor for IA. Most frequent risk factors were corticosteroids (77.2%), SOT (46.5%), SARS-CoV2 (29.7%) and CMV replication (28.7%). 89.3% were pulmonary IA with 6 cases (5.4%) of disseminated infection. A. fumigatus was the most frequent species 48 (51.6%). 13 cases (14%) were caused by cryptic Aspergillus spp. Non-neutropenic patients, compared to neutropenic patients, were more likely to have positive fungal cultures (83.2% versus 54.5%, p = 0.023[NS]), and not to present a halo sign (7.4% versus 45.5%, p = 0.003 [NS]). In addition, in non-neutropenic patients, compared to neutropenic patients, there was a trend towards a greater probability of positive GM from BAL (81.3% versus 66.7%, p = 0.304) and a trend towards a lower probability of positive serum GM (25.7% versus 45.5%, p = 0.137). 41/112 (36.6%) cases presented breakthrough IFI and in 51.2%, (21/41 cases), the isolate was resistant to the prior antifungal. One presented A. fumigatus with the TR34-L98H mutation.
conclusionRisk factors different than neutropenia are currently the most common in IA. The clinical presentation in non-neutropenic patients differs from neutropenic. Resistance to antifungals is emerging especially in breakthrough IA.
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