{"id":28743,"date":"2025-08-23T04:43:00","date_gmt":"2025-08-22T20:43:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28743"},"modified":"2025-08-23T06:19:32","modified_gmt":"2025-08-22T22:19:32","slug":"clin-infect-dis%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e4%be%b5%e8%a2%ad%e6%80%a7%e8%82%ba%e6%9b%b2%e9%9c%89%e8%8f%8c%e7%97%85%e6%82%a3%e8%80%85%e7%9a%84%e8%af%8a%e6%96%ad%e7%ad%96%e7%95%a5","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28743","title":{"rendered":"[Clin Infect Dis\u53d1\u8868\u8bba\u6587]\uff1a\u4fb5\u88ad\u6027\u80ba\u66f2\u9709\u83cc\u75c5\u60a3\u8005\u7684\u8bca\u65ad\u7b56\u7565"},"content":{"rendered":"\n

JOURNAL ARTICLE<\/p>\n\n\n\n

Performance of Diagnostic Algorithms in Patients With Invasive Pulmonary Aspergillosis<\/h1>\n\n\n\n

Stefan Hatzl, Christina Geiger, Lisa Kriegl, et al<\/h3>\n\n\n\n

Clin Infect Dis 2025: 80: 1080-1087<\/h3>\n\n\n\n

https:\/\/doi.org\/10.1093\/cid\/ciae633<\/a><\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Background<\/p>\n\n\n\n

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.<\/p>\n\n\n\n

Methods<\/p>\n\n\n\n

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.<\/p>\n\n\n\n

Results<\/p>\n\n\n\n

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.<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions<\/p>\n\n\n\n

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.<\/p>\n","protected":false},"excerpt":{"rendered":"

JOURNAL ARTICLE Performance of Diagnostic Algorithms in […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28743"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28743"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28743\/revisions"}],"predecessor-version":[{"id":28929,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28743\/revisions\/28929"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28743"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28743"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28743"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}