Invasive aspergillosis in adult patients in Australia and New Zealand: 2017–2020

New and emerging risks for invasive aspergillosis (IA) bring the need for contemporary analyses of the epidemiology and outcomes of IA, in order to improve clinical practice. The study was a retrospective, multicenter, cohort design of proven and probable IA in adults from 10 Australasian tertiary c...

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Published in:The Lancet regional health. Western Pacific 2023-11, Vol.40, p.100888, Article 100888
Main Authors: Tio, Shio Yen, Chen, Sharon C.-A., Hamilton, Kate, Heath, Christopher H., Pradhan, Alyssa, Morris, Arthur J., Korman, Tony M., Morrissey, Orla, Halliday, Catriona L., Kidd, Sarah, Spelman, Timothy, Brell, Nadiya, McMullan, Brendan, Clark, Julia E., Mitsakos, Katerina, Hardiman, Robyn P., Williams, Phoebe, Campbell, Anita J., Beardsley, Justin, Van Hal, Sebastiaan, Yong, Michelle K., Worth, Leon J., Slavin, Monica A.
Format: Article
Language:English
Subjects:
Australasia
Epidemiology
Invasive aspergillosis
Medicin och hälsovetenskap
Outcome
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Summary:New and emerging risks for invasive aspergillosis (IA) bring the need for contemporary analyses of the epidemiology and outcomes of IA, in order to improve clinical practice. The study was a retrospective, multicenter, cohort design of proven and probable IA in adults from 10 Australasian tertiary centres (January 2017–December 2020). Descriptive analyses were used to report patients’ demographics, predisposing factors, mycological characteristics, diagnosis and management. Accelerated failure-time model was employed to determine factor(s) associated with 90-day all-cause mortality (ACM). Of 382 IA episodes, 221 (in 221 patients) fulfilled inclusion criteria – 53 proven and 168 probable IA. Median patient age was 61 years (IQR 51–69). Patients with haematologic malignancies (HM) comprised 49.8% of cases. Fifteen patients (6.8%) had no pre-specified immunosuppression and eleven patients (5.0%) had no documented comorbidity. Only 30% of patients had neutropenia. Of 170 isolates identified, 40 (23.5%) were identified as non-Aspergillus fumigatus species complex. Azole-resistance was present in 3/46 (6.5%) of A. fumigatus sensu stricto isolates. Ninety-day ACM was 30.3%. HM (HR 1.90; 95% CI 1.04–3.46, p = 0.036) and ICU admission (HR 4.89; 95% CI 2.93–8.17, p 
ISSN:2666-6065
2666-6065
DOI:10.1016/j.lanwpc.2023.100888