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Influenza-associated invasive aspergillosis in patients admitted to the intensive care unit in Sweden : a prospective multicentre cohort study

Krifors, Anders (author)
Uppsala University,Karolinska Institute,Uppsala universitet,Centrum för klinisk forskning, Västerås,Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden,Karolinska Inst, Sweden; Uppsala Univ, Sweden,Västmanland Hospital
Blennow, Ola (author)
Karolinska Institute,Karolinska University Hospital
Påhlman, Lisa I (author)
Lund University,Lunds universitet,Luftvägar, patogener, immunförsvar,Forskargrupper vid Lunds universitet,WCMM- Wallenberg center för molekylär medicinsk forskning,Medicinska fakulteten,Airways, pathogens, innate immunity,Lund University Research Groups,WCMM-Wallenberg Centre for Molecular Medicine,Faculty of Medicine,Skåne University Hospital
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Gille-Johnson, Patrik (author)
Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden,Danderyd Hosp, Sweden
Janols, Helena (author)
Uppsala University,Uppsala universitet,Infektionsmedicin,Uppsala Univ, Sweden
Lipcsey, Miklós (author)
Uppsala University,Uppsala universitet,Hedenstiernalaboratoriet,Uppsala Univ, Sweden
Källman, Jan, 1958- (author)
Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Infectious Diseases,Orebro Univ Hosp, Sweden; Orebro Univ, Sweden,Örebro University Hospital
Tham, Johan (author)
Lund University,Lunds universitet,Klinisk infektionsmedicin,Forskargrupper vid Lunds universitet,Clinical infection medicine,Lund University Research Groups,Skåne University Hospital
Stjärne Aspelund, Anna (author)
Lund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
Ljungquist, Oskar (author)
Lund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital
Hammarskjöld, Fredrik (author)
Linköping University,Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Ryhov Cty Hosp, Sweden,Ryhov County Hospital, Jönköping
Hällgren, Anita (author)
Linköping University,Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland
de Geer, Lina (author)
Linköping University,Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US
Lemberg, Marie (author)
Department of Anesthesia and Intensive Care, Västerås Hospital, Västerås, Sweden,Vasteras Hosp, Sweden,Västmanland Hospital
Petersson, Johan (author)
Karolinska Institute,Karolinska University Hospital
Castegren, Markus (author)
Uppsala University,Karolinska Institute,Uppsala universitet,Karolinska Institutet,Centrum för klinisk forskning i Sörmland (CKFD),Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden,Karolinska Inst, Sweden; Uppsala Univ, Sweden,Mälar Hospital
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 (creator_code:org_t)
Taylor & Francis, 2024
2024
English.
In: Infectious Diseases. - : Taylor & Francis. - 2374-4235 .- 2374-4243. ; 56:2, s. 110-115
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • BACKGROUND: The purpose of this study was to prospectively investigate the incidence of influenza-associated pulmonary aspergillosis (IAPA) in influenza patients admitted to intensive care units in Sweden.METHODS: The study included consecutive adult patients with PCR-verified influenza A or B in 12 Swedish intensive care units (ICUs) over four influenza seasons (2019-2023). Patients were screened using serum galactomannan and β-d-glucan tests and fungal culture of a respiratory sample at inclusion and weekly during the ICU stay. Bronchoalveolar lavage was performed if clinically feasible. IAPA was classified according to recently proposed case definitions.RESULTS: The cohort included 55 patients; 42% were female, and the median age was 59 (IQR 48-71) years. All patients had at least one galactomannan test, β-d-glucan test and respiratory culture performed. Bronchoalveolar lavage was performed in 24 (44%) of the patients. Five (9%, 95% CI 3.8% - 20.4%) patients were classified as probable IAPA, of which four lacked classical risk factors. The overall ICU mortality was significantly higher among IAPA patients than non-IAPA patients (60% vs 8%, p = 0.01).CONCLUSIONS: The study represents the first prospective investigation of IAPA incidence. The 9% incidence of IAPA confirms the increased risk of invasive pulmonary aspergillosis among influenza patients admitted to the ICU. Therefore, it appears reasonable to implement a screening protocol for the early diagnosis and treatment of IAPA in influenza patients receiving intensive care.TRIAL REGISTRATION: ClinicalTrials.gov NCT04172610, registered November 21, 2019.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Infectious Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

Influenza
influenza-associated aspergillosis
intensive care medicine
invasive aspergillosis

Publication and Content Type

ref (subject category)
art (subject category)

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