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Which algorithm diagnoses invasive pulmonary aspergillosis best in ICU patients with COPD?

2017; European Respiratory Society; Volume: 50; Issue: 3 Linguagem: Inglês

10.1183/13993003.00532-2017

1399-3003

Pierre Bulpa, Benoît Bihin, George Dimοpoulos, Fabio Silvio Taccone, Anne‐Marie Van den Abeele, Benoît Misset, Wouter Meersseman, Herbert Spapen, Teresa Cardoso, Pierre‐Emmanuel Charles, Jordi Rello, Dirk Vogelaers, Stijn Blot,

Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis

Invasive pulmonary aspergillosis (IPA) is a potentially lethal opportunistic infection, mainly affecting immunocompromised patients, particularly those with prolonged neutropenia [1]. Several reports have shown that Aspergillus spp. can also cause IPA in patients with a priori less severe immune dysfunction, such as those in intensive care units (ICUs) [2–5] or with chronic obstructive pulmonary disease (COPD) [5–8]. In these patients, diagnosis of IPA remains a challenge, because the reference diagnostic criteria (defined by the European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC/MSG)) were developed for research in high-risk patients and not specifically for patients in the ICU or patients with COPD [9]. Two alternative algorithms have been proposed for this setting: the COPD algorithm for patients with COPD [6] and the Clinical algorithm for patients in the ICU [10]. In ICU COPD patients, the Clinical algorithm seems to be more useful to diagnose IPA than the COPD or EORTC/MSG ones The AspICU Study Investigators are as follows: Miguel Blasco-Navalpotro, Hospital Universitario Severo Ochoa (Madrid, Spain); Stijn Blot, Ghent University (Ghent, Belgium); Nele Brusselaers, Ghent University Hospital, (Ghent, Belgium); Pierre Bulpa, Mont-Godinne University Hospital (Yvoir, Belgium); Teresa Cardoso, Hospital de Santo Antonio (Porto, Portugal); Pierre-Emmanuel Charles, Dijon University Hospital (Dijon, France); Didier Clause, Cliniques de l'Europe (Brussels, Belgium); Patricia Courouble, Cliniques Universitaires Saint Luc (Brussels, Belgium); Emmanuel De Laere, Heilig Hartziekenhuis Roeselaere-Menen (Roeselaere, Belgium); George Dimopoulos, University Hospital Attikon (Athens, Greece); Frédéric Forêt, Centre Hospitalier Régional Mons-Warquignies (Mons, Belgium); Dan Li, Shangai Public Health Clinical Center (Shangai, China); Claude Martin, Assistance publique hôpitaux de Marseille, (Marseille, France); Shahram Mashayekhi, Centre Hospitalier Grand Hornu (Hornu, Belgium); Wouter Meersseman, Universitair Ziekenhuis Gasthuisberg (Leuven, Belgium); Benoit Misset, Hôpital Saint-Joseph (Paris, France); José Artur Paiva, Hospital de Sao Joao, (Porto, Portugal); Paulo Mergulhao, Hospital de Sao Joao (Porto, Portugal); Alessandro Pasqualotto, Santa Casa-Complexo Hospitalar (Porto Allegre, Brazil); Marcos Pérez, Vall d'Hebron University Hospital (Barcelona, Spain); Ratna Rao, Apollo Hospital (Hyderabad, India); Jordi Rello, Joan XXIII University Hospital (Tarragona, Spain) and Vall d'Hebron University Hospital (Barcelona, Spain); Jessica Souto, Vall d'Hebron University Hospital (Barcelona, Spain); Herbert Spapen, Brussels University Hospital (Brussels, Belgium); Fabio Silvio Taccone, Hôpital Erasme (Brussels, Belgium); Anne-Marie Van den Abeele, AZ Sint Lucas, (Ghent, Belgium); Koenraad Vandewoude, Ghent University Hospital, (Ghent, Belgium); and Dirk Vogelaers, Ghent University Hospital (Ghent, Belgium).