Invasive aspergillosis in the intensive care unit

Dimοpoulos, George; Frantzeskaki, Frantezeska; Poulakou, Garyfallia; Armaganidis, Apostolos

doi:10.1111/j.1749-6632.2012.06805.x

Cited by 58 publications

(53 citation statements)

References 74 publications

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“…Although significant, the mortality is lower than reported for other groups of patients with IPA. Mortality in critically ill patients with IPA was reported to be 59-95% [52,53]. In patients with severe liver disease, mortality from IPA exceeds 70% [54].…”

Section: Discussionmentioning

confidence: 97%

Invasive pulmonary aspergillosis in patients with influenza infection: report of two cases and systematic review of the literature

Alshabani

Haq

Miyakawa

et al. 2014

Expert Review of Respiratory Medicine

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Superinfection or coinfections are major causes of morbidity and mortality in patients with influenza. There are limited data on invasive pulmonary aspergillosis (IPA) in this setting. We conducted a systematic review of the literature for patients with IPA following influenza infection. A total of 68 patients (two reported from our institution and 66 identified by literature review) were analyzed. The majority of patients had underlying comorbid illnesses. Overall, the mortality rate in this cohort was 47%. On multivariate analysis, H1N1 infection was associated with better outcome (odds ratio [OR]: 0.19; 95% CI: 0.05-0.67; p = 0.010), whereas corticosteroid therapy during hospitalization was associated with worse outcome (OR: 13.5; 95% CI: 3.65-49.67; p < 0.0001). In conclusion, IPA is an emerging serious infection in patients with influenza. A high index of suspicion is necessary for the timely identification and treatment of these patients.

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Section: Discussionmentioning

confidence: 97%

Invasive pulmonary aspergillosis in patients with influenza infection: report of two cases and systematic review of the literature

Alshabani

Haq

Miyakawa

et al. 2014

Expert Review of Respiratory Medicine

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“…S-1 in the Supporting information). This fungus leads to increased mortality among immunocompromised patients suffering from invasive aspergillosis [48][49][50][51] and is also associated with crop contamination [52]. Detection of Aspergillus through unique DNA sequences is significant because PCR methods are faster and more conclusive than the traditional means of identifying Aspergillus species based on morphology observed in microbiology laboratory cell cultures.…”

Section: Characterization Of the Difference Between True And Measuredmentioning

confidence: 99%

Reversible phospholipid nanogels for deoxyribonucleic acid fragment size determinations up to 1500 base pairs and integrated sample stacking

Durney

Bachert

Sloane

et al. 2015

Analytica Chimica Acta

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Phospholipid additives are a cost-effective medium to separate deoxyribonucleic acid (DNA) fragments and possess a thermally-responsive viscosity. This provides a mechanism to easily create and replace a highly viscous nanogel in a narrow bore capillary with only a 10°C change in temperature. Preparations composed of dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and 1,2-dihexanoyl-sn-glycero-3-phosphocholine (DHPC) self-assemble, forming structures such as nanodisks and wormlike micelles. Factors that influence the morphology of a particular DMPC-DHPC preparation include the concentration of lipid in solution, the temperature, and the ratio of DMPC and DHPC. It has previously been established that an aqueous solution containing 10% phospholipid with a ratio of [DMPC]/[DHPC]=2.5 separates DNA fragments with nearly single base resolution for DNA fragments up to 500 base pairs in length, but beyond this size the resolution decreases dramatically. A new DMPC-DHPC medium is developed to effectively separate and size DNA fragments up to 1500 base pairs by decreasing the total lipid concentration to 2.5%. A 2.5% phospholipid nanogel generates a resolution of 1% of the DNA fragment size up to 1500 base pairs. This increase in the upper size limit is accomplished using commercially available phospholipids at an even lower material cost than is achieved with the 10% preparation. The separation additive is used to evaluate size markers ranging between 200 and 1500 base pairs in order to distinguish invasive strains of Streptococcus pyogenes and Aspergillus species by harnessing differences in gene sequences of collagen-like proteins in these organisms. For the first time, a reversible stacking gel is integrated in a capillary sieving separation by utilizing the thermally-responsive viscosity of these self-assembled phospholipid preparations. A discontinuous matrix is created that is composed of a cartridge of highly viscous phospholipid assimilated into a separation matrix of low viscosity. DNA sample stacking is facilitated with longer injection times without sacrificing separation efficiency.

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“…fumigatus, A. flavus, A. nidulans, A. niger, and A. terreus are among the most common agents of Aspergillus-opportunistic disease in humans (8). However, the identification of these organisms remains challenging.…”

mentioning

confidence: 99%

“…are also important opportunistic pathogens. Among these, A. fumigatus is the most common etiologic agent of invasive aspergillosis (IA), a disease associated with high rates of mortality (17% to 60%) in severely immunocompromised patients (5)(6)(7)(8). As a noninvasive pathogen, A. fumigatus is also associated with allergic sensitization for 6% to 24% of the general population, with A. fumigatus-specific allergies noted in 45% of pediatric asthmatics and 70% in adult asthmatics (9).…”

mentioning

confidence: 99%

Aspergillus Collagen-Like Genes ( acl ): Identification, Sequence Polymorphism, and Assessment for PCR-Based Pathogen Detection

Tuntevski

Durney

Snyder

et al. 2013

Appl Environ Microbiol

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fThe genus Aspergillus is a burden to public health due to its ubiquitous presence in the environment, its production of allergens, and wide demographic susceptibility among cystic fibrosis, asthmatic, and immunosuppressed patients. Current methods of detection of Aspergillus colonization and infection rely on lengthy morphological characterization or nonstandardized serological assays that are restricted to identifying a fungal etiology. Collagen-like genes have been shown to exhibit species-specific conservation across the noncollagenous regions as well as strain-specific polymorphism in the collagen-like regions. Here we assess the conserved region of the Aspergillus collagen-like (acl) genes and explore the application of PCR amplicon size-based discrimination among the five most common etiologic species of the Aspergillus genus, including Aspergillus fumigatus, A. flavus, A. nidulans, A. niger, and A. terreus. Genetic polymorphism and phylogenetic analysis of the aclF1 gene were additionally examined among the available strains. Furthermore, the applicability of the PCR-based assay to identification of these five species in cultures derived from sputum and bronchoalveolar fluid from 19 clinical samples was explored. Application of capillary electrophoresis on nanogels was additionally demonstrated to improve the discrimination between Aspergillus species. Overall, this study demonstrated that Aspergillus acl genes could be used as PCR targets to discriminate between clinically relevant Aspergillus species. Future studies aim to utilize the detection of Aspergillus acl genes in PCR and microfluidic applications to determine the sensitivity and specificity for the identification of Aspergillus colonization and invasive aspergillosis in immunocompromised subjects.

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Invasive aspergillosis in the intensive care unit

Cited by 58 publications

References 74 publications

Invasive pulmonary aspergillosis in patients with influenza infection: report of two cases and systematic review of the literature

Invasive pulmonary aspergillosis in patients with influenza infection: report of two cases and systematic review of the literature

Reversible phospholipid nanogels for deoxyribonucleic acid fragment size determinations up to 1500 base pairs and integrated sample stacking

Aspergillus Collagen-Like Genes ( acl ): Identification, Sequence Polymorphism, and Assessment for PCR-Based Pathogen Detection

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