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"Faces" of the day:

Klara Konstanze Pohl

Federica Piani

Cara Lavinia Shirin Rech

Kathrin Eller

Christine Moissl-Eichinger

Dajie Marschik

Eleonore Fröhlich

Konstantin Adrian Klötzer

Florian Moik

Marco Eigenfeld

Mahmoud Abdellatif

Benjamin Gottschalk

Christian Diener

Peter Marschik

Simon Sedej

Sascha Ahyai

Roland Malli

Wolfgang Graier

Selected Publication:

SHR Neuro Cancer Cardio Lipid Metab Microb

Hatzl, S; Geiger, C; Kriegl, L; Scholz, L; Reisinger, AC; Kreuzer, P; Fruhwald, S; Wölfler, A; Reinisch, A; von, Lewinski, D; Schilcher, G; Hoenigl, M; Eller, P; Krause, R.
Performance of Diagnostic Algorithms in Patients With Invasive Pulmonary Aspergillosis.
Clin Infect Dis. 2025; 80(5):1080-1087 Doi: 10.1093/cid/ciae633 [OPEN ACCESS]
Web of Science PubMed FullText FullText_MUG

Leading authors Med Uni Graz: Hatzl Stefan; Krause Robert
Co-authors Med Uni Graz: Eller Philipp; Fruhwald Sonja; Hönigl Martin; Kreuzer Philipp; Kriegl Lisa; Reinisch Andreas; Reisinger Alexander Christian; Schilcher Gernot; Scholz Laura; von Lewinski Dirk; Wölfler Albert
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Abstract:: BACKGROUND: Invasive 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. METHODS: We 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. RESULTS: Among 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. CONCLUSIONS: EORTC-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.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; Invasive Pulmonary Aspergillosis - diagnosis; Male - administration & dosage; Retrospective Studies - administration & dosage; Female - administration & dosage; Middle Aged - administration & dosage; Algorithms - administration & dosage; Aged - administration & dosage; Intensive Care Units - administration & dosage; Adult - administration & dosage; Biomarkers - administration & dosage
Find related publications in this database (Keywords): invasive pulmonary aspergillosis; ICU; host factors; classification; IPA