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Influenza-associate...
Influenza-associated invasive aspergillosis in patients admitted to the intensive care unit in Sweden : a prospective multicentre cohort study
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- 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
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- Blennow, Ola (author)
- Karolinska Institute,Karolinska University Hospital
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- 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
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- Janols, Helena (author)
- Uppsala University,Uppsala universitet,Infektionsmedicin,Uppsala Univ, Sweden
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- Lipcsey, Miklós (author)
- Uppsala University,Uppsala universitet,Hedenstiernalaboratoriet,Uppsala Univ, Sweden
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- 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
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- Tham, Johan (author)
- Lund University,Lunds universitet,Klinisk infektionsmedicin,Forskargrupper vid Lunds universitet,Clinical infection medicine,Lund University Research Groups,Skåne University Hospital
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- 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
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- 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
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- Hammarskjöld, Fredrik (author)
- Linköping University,Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Ryhov Cty Hosp, Sweden,Ryhov County Hospital, Jönköping
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- Hällgren, Anita (author)
- Linköping University,Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland
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- de Geer, Lina (author)
- Linköping University,Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US
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- Lemberg, Marie (author)
- Department of Anesthesia and Intensive Care, Västerås Hospital, Västerås, Sweden,Vasteras Hosp, Sweden,Västmanland Hospital
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- Petersson, Johan (author)
- Karolinska Institute,Karolinska University Hospital
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- 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.
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In: Infectious Diseases. - : Taylor & Francis. - 2374-4235 .- 2374-4243. ; 56:2, s. 110-115
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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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- By the author/editor
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Krifors, Anders
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Blennow, Ola
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Påhlman, Lisa I
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Gille-Johnson, P ...
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Janols, Helena
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Lipcsey, Miklós
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Källman, Jan, 19 ...
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Tham, Johan
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Stjärne Aspelund ...
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Ljungquist, Oska ...
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Hammarskjöld, Fr ...
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Hällgren, Anita
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de Geer, Lina
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Lemberg, Marie
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Petersson, Johan
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Castegren, Marku ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Infectious Disea ...
- By the university
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Örebro University
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Karolinska Institutet
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Uppsala University
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Linköping University
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Lund University