Diagnosis and management of Aspergillus diseases: Executive summary of the 2017 ESCMID-ECMM-ERS guideline

A. J. Ullmann; J. M. Aguado; S. Arikan-Akdagli; D. W. Denning; A. H. Groll; K. Lagrou; C. Lass-Flörl; R. E. Lewis; P. Munoz; P. E. Verweij; A. Warris; F. Ader; M. Akova; M. C. Arendrup; R. A. Barnes; C. Beigelman-Aubry; S. Blot; E. Bouza; R. J.M. Brüggemann; D. Buchheidt; J. Cadranel; E. Castagnola; A. Chakrabarti; M. Cuenca-Estrella; G. Dimopoulos; J. Fortun; J. P. Gangneux; J. Garbino; W. J. Heinz; R. Herbrecht; C. P. Heussel; C. C. Kibbler; N. Klimko; B. J. Kullberg; C. Lange; T. Lehrnbecher; J. Löffler; O. Lortholary; J. Maertens; O. Marchetti; J. F. Meis; Livio Pagano; P. Ribaud; M. Richardson; E. Roilides; M. Ruhnke; Maurizio Sanguinetti; D. C. Sheppard; J. Sinkó; A. Skiada; M. J.G.T. Vehreschild; C. Viscoli; O. A. Cornely

doi:10.1016/j.cmi.2018.01.002

Diagnosis and management of Aspergillus diseases: Executive summary of the 2017 ESCMID-ECMM-ERS guideline

A. J. Ullmann
, J. M. Aguado
, S. Arikan-Akdagli
, D. W. Denning
, A. H. Groll
, K. Lagrou
, C. Lass-Flörl
, R. E. Lewis
, P. Munoz
, P. E. Verweij
, A. Warris
, F. Ader
, M. Akova
, M. C. Arendrup
, R. A. Barnes
, C. Beigelman-Aubry
, S. Blot
, E. Bouza
, R. J.M. Brüggemann
, D. Buchheidt

J. Cadranel, E. Castagnola, A. Chakrabarti, M. Cuenca-Estrella, G. Dimopoulos, J. Fortun, J. P. Gangneux, J. Garbino, W. J. Heinz, R. Herbrecht, C. P. Heussel, C. C. Kibbler, N. Klimko, B. J. Kullberg, C. Lange, T. Lehrnbecher, J. Löffler, O. Lortholary, J. Maertens, O. Marchetti, J. F. Meis, Livio Pagano, P. Ribaud, M. Richardson, E. Roilides, M. Ruhnke, Maurizio Sanguinetti, D. C. Sheppard, J. Sinkó, A. Skiada, M. J.G.T. Vehreschild, C. Viscoli, O. A. Cornely

University of Würzburg
University Hospital of Madrid
Hacettepe University
ECMM Excellence Centre of Medical Mycology
University of Münster
KU Leuven
Innsbruck Medical University
Alma Mater Studiorum University of Bologna
Hospital General Universitario Gregorio Marañon
Radboud University Nijmegen
University of Aberdeen
Hospices Civils de Lyon-Centre Léon Bérard
Statens Serum Institut
Cardiff University
University of Lausanne
Ghent University
Heidelberg University
Hôpital Tenon
IRCCS Istituto Giannina Gaslini - Genova
Postgraduate Institute of Medical Education and Research
Instituto de Salud Carlos III
National and Kapodistrian University of Athens
Hospital Ramon y Cajal
CHU de Rennes
University of Geneva
Université de Strasbourg
University College London
North-Western State Medical University named after I.I. Mechnikov
University of Lübeck
Goethe University Frankfurt
University of Paris
Canisius Wilhelmina Hospital
Université Paris Cité
Hippokration Hospital
Paracelsus-Klinik Osnabrück
McGill University
Szent Laszlo Hospital
University of Cologne
San Martino Hospital Genoa

Risultato della ricerca: Contributo in rivista › Articolo

410 Citazioni (Scopus)

Abstract

The European Society for Clinical Microbiology and Infectious Diseases, the European Confederation of Medical Mycology and the European Respiratory Society Joint Clinical Guidelines focus on diagnosis and management of aspergillosis. Of the numerous recommendations, a few are summarized here. Chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA) are strongly recommended. For diagnosis, direct microscopy, preferably using optical brighteners, histopathology and culture are strongly recommended. Serum and BAL galactomannan measures are recommended as markers for the diagnosis of IA. PCR should be considered in conjunction with other diagnostic tests. Pathogen identification to species complex level is strongly recommended for all clinically relevant Aspergillus isolates; antifungal susceptibility testing should be performed in patients with invasive disease in regions with resistance found in contemporary surveillance programmes. Isavuconazole and voriconazole are the preferred agents for first-line treatment of pulmonary IA, whereas liposomal amphotericin B is moderately supported. Combinations of antifungals as primary treatment options are not recommended. Therapeutic drug monitoring is strongly recommended for patients receiving posaconazole suspension or any form of voriconazole for IA treatment, and in refractory disease, where a personalized approach considering reversal of predisposing factors, switching drug class and surgical intervention is also strongly recommended. Primary prophylaxis with posaconazole is strongly recommended in patients with acute myelogenous leukaemia or myelodysplastic syndrome receiving induction chemotherapy. Secondary prophylaxis is strongly recommended in high-risk patients. We strongly recommend treatment duration based on clinical improvement, degree of immunosuppression and response on imaging.

Lingua originale	Inglese
pagine (da-a)	e1-e38
Rivista	Clinical Microbiology and Infection
Volume	24
DOI	https://doi.org/10.1016/j.cmi.2018.01.002
Stato di pubblicazione	Pubblicato - 2018

OSS delle Nazioni Unite

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SDG 3 Salute e benessere

Keywords

Aspergillosis
Diagnosis
Haematology
Infectious Diseases
Invasive fungal infection
Microbiology (medical)
Transplantation
Treatment

Accesso al documento

10.1016/j.cmi.2018.01.002

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Ullmann, A. J., Aguado, J. M., Arikan-Akdagli, S., Denning, D. W., Groll, A. H., Lagrou, K., Lass-Flörl, C., Lewis, R. E., Munoz, P., Verweij, P. E., Warris, A., Ader, F., Akova, M., Arendrup, M. C., Barnes, R. A., Beigelman-Aubry, C., Blot, S., Bouza, E., Brüggemann, R. J. M., ... Cornely, O. A. (2018). Diagnosis and management of Aspergillus diseases: Executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clinical Microbiology and Infection, 24, e1-e38. https://doi.org/10.1016/j.cmi.2018.01.002

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title = "Diagnosis and management of Aspergillus diseases: Executive summary of the 2017 ESCMID-ECMM-ERS guideline",

abstract = "The European Society for Clinical Microbiology and Infectious Diseases, the European Confederation of Medical Mycology and the European Respiratory Society Joint Clinical Guidelines focus on diagnosis and management of aspergillosis. Of the numerous recommendations, a few are summarized here. Chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA) are strongly recommended. For diagnosis, direct microscopy, preferably using optical brighteners, histopathology and culture are strongly recommended. Serum and BAL galactomannan measures are recommended as markers for the diagnosis of IA. PCR should be considered in conjunction with other diagnostic tests. Pathogen identification to species complex level is strongly recommended for all clinically relevant Aspergillus isolates; antifungal susceptibility testing should be performed in patients with invasive disease in regions with resistance found in contemporary surveillance programmes. Isavuconazole and voriconazole are the preferred agents for first-line treatment of pulmonary IA, whereas liposomal amphotericin B is moderately supported. Combinations of antifungals as primary treatment options are not recommended. Therapeutic drug monitoring is strongly recommended for patients receiving posaconazole suspension or any form of voriconazole for IA treatment, and in refractory disease, where a personalized approach considering reversal of predisposing factors, switching drug class and surgical intervention is also strongly recommended. Primary prophylaxis with posaconazole is strongly recommended in patients with acute myelogenous leukaemia or myelodysplastic syndrome receiving induction chemotherapy. Secondary prophylaxis is strongly recommended in high-risk patients. We strongly recommend treatment duration based on clinical improvement, degree of immunosuppression and response on imaging.",

keywords = "Aspergillosis, Diagnosis, Haematology, Infectious Diseases, Invasive fungal infection, Microbiology (medical), Transplantation, Treatment, Aspergillosis, Diagnosis, Haematology, Infectious Diseases, Invasive fungal infection, Microbiology (medical), Transplantation, Treatment",

author = "Ullmann, \{A. J.\} and Aguado, \{J. M.\} and S. Arikan-Akdagli and Denning, \{D. W.\} and Groll, \{A. H.\} and K. Lagrou and C. Lass-Fl{\"o}rl and Lewis, \{R. E.\} and P. Munoz and Verweij, \{P. E.\} and A. Warris and F. Ader and M. Akova and Arendrup, \{M. C.\} and Barnes, \{R. A.\} and C. Beigelman-Aubry and S. Blot and E. Bouza and Br{\"u}ggemann, \{R. J.M.\} and D. Buchheidt and J. Cadranel and E. Castagnola and A. Chakrabarti and M. Cuenca-Estrella and G. Dimopoulos and J. Fortun and Gangneux, \{J. P.\} and J. Garbino and Heinz, \{W. J.\} and R. Herbrecht and Heussel, \{C. P.\} and Kibbler, \{C. C.\} and N. Klimko and Kullberg, \{B. J.\} and C. Lange and T. Lehrnbecher and J. L{\"o}ffler and O. Lortholary and J. Maertens and O. Marchetti and Meis, \{J. F.\} and Livio Pagano and P. Ribaud and M. Richardson and E. Roilides and M. Ruhnke and Maurizio Sanguinetti and Sheppard, \{D. C.\} and J. Sink{\'o} and A. Skiada and Vehreschild, \{M. J.G.T.\} and C. Viscoli and Cornely, \{O. A.\}",

year = "2018",

doi = "10.1016/j.cmi.2018.01.002",

language = "English",

volume = "24",

pages = "e1--e38",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier B.V.",

}

Ullmann, AJ, Aguado, JM, Arikan-Akdagli, S, Denning, DW, Groll, AH, Lagrou, K, Lass-Flörl, C, Lewis, RE, Munoz, P, Verweij, PE, Warris, A, Ader, F, Akova, M, Arendrup, MC, Barnes, RA, Beigelman-Aubry, C, Blot, S, Bouza, E, Brüggemann, RJM, Buchheidt, D, Cadranel, J, Castagnola, E, Chakrabarti, A, Cuenca-Estrella, M, Dimopoulos, G, Fortun, J, Gangneux, JP, Garbino, J, Heinz, WJ, Herbrecht, R, Heussel, CP, Kibbler, CC, Klimko, N, Kullberg, BJ, Lange, C, Lehrnbecher, T, Löffler, J, Lortholary, O, Maertens, J, Marchetti, O, Meis, JF, Pagano, L, Ribaud, P, Richardson, M, Roilides, E, Ruhnke, M, Sanguinetti, M, Sheppard, DC, Sinkó, J, Skiada, A, Vehreschild, MJGT, Viscoli, C & Cornely, OA 2018, 'Diagnosis and management of Aspergillus diseases: Executive summary of the 2017 ESCMID-ECMM-ERS guideline', Clinical Microbiology and Infection, vol. 24, pagg. e1-e38. https://doi.org/10.1016/j.cmi.2018.01.002

TY - JOUR

T1 - Diagnosis and management of Aspergillus diseases: Executive summary of the 2017 ESCMID-ECMM-ERS guideline

AU - Ullmann, A. J.

AU - Aguado, J. M.

AU - Arikan-Akdagli, S.

AU - Denning, D. W.

AU - Groll, A. H.

AU - Lagrou, K.

AU - Lass-Flörl, C.

AU - Lewis, R. E.

AU - Munoz, P.

AU - Verweij, P. E.

AU - Warris, A.

AU - Ader, F.

AU - Akova, M.

AU - Arendrup, M. C.

AU - Barnes, R. A.

AU - Beigelman-Aubry, C.

AU - Blot, S.

AU - Bouza, E.

AU - Brüggemann, R. J.M.

AU - Buchheidt, D.

AU - Cadranel, J.

AU - Castagnola, E.

AU - Chakrabarti, A.

AU - Cuenca-Estrella, M.

AU - Dimopoulos, G.

AU - Fortun, J.

AU - Gangneux, J. P.

AU - Garbino, J.

AU - Heinz, W. J.

AU - Herbrecht, R.

AU - Heussel, C. P.

AU - Kibbler, C. C.

AU - Klimko, N.

AU - Kullberg, B. J.

AU - Lange, C.

AU - Lehrnbecher, T.

AU - Löffler, J.

AU - Lortholary, O.

AU - Maertens, J.

AU - Marchetti, O.

AU - Meis, J. F.

AU - Pagano, Livio

AU - Ribaud, P.

AU - Richardson, M.

AU - Roilides, E.

AU - Ruhnke, M.

AU - Sanguinetti, Maurizio

AU - Sheppard, D. C.

AU - Sinkó, J.

AU - Skiada, A.

AU - Vehreschild, M. J.G.T.

AU - Viscoli, C.

AU - Cornely, O. A.

PY - 2018

Y1 - 2018

N2 - The European Society for Clinical Microbiology and Infectious Diseases, the European Confederation of Medical Mycology and the European Respiratory Society Joint Clinical Guidelines focus on diagnosis and management of aspergillosis. Of the numerous recommendations, a few are summarized here. Chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA) are strongly recommended. For diagnosis, direct microscopy, preferably using optical brighteners, histopathology and culture are strongly recommended. Serum and BAL galactomannan measures are recommended as markers for the diagnosis of IA. PCR should be considered in conjunction with other diagnostic tests. Pathogen identification to species complex level is strongly recommended for all clinically relevant Aspergillus isolates; antifungal susceptibility testing should be performed in patients with invasive disease in regions with resistance found in contemporary surveillance programmes. Isavuconazole and voriconazole are the preferred agents for first-line treatment of pulmonary IA, whereas liposomal amphotericin B is moderately supported. Combinations of antifungals as primary treatment options are not recommended. Therapeutic drug monitoring is strongly recommended for patients receiving posaconazole suspension or any form of voriconazole for IA treatment, and in refractory disease, where a personalized approach considering reversal of predisposing factors, switching drug class and surgical intervention is also strongly recommended. Primary prophylaxis with posaconazole is strongly recommended in patients with acute myelogenous leukaemia or myelodysplastic syndrome receiving induction chemotherapy. Secondary prophylaxis is strongly recommended in high-risk patients. We strongly recommend treatment duration based on clinical improvement, degree of immunosuppression and response on imaging.

AB - The European Society for Clinical Microbiology and Infectious Diseases, the European Confederation of Medical Mycology and the European Respiratory Society Joint Clinical Guidelines focus on diagnosis and management of aspergillosis. Of the numerous recommendations, a few are summarized here. Chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA) are strongly recommended. For diagnosis, direct microscopy, preferably using optical brighteners, histopathology and culture are strongly recommended. Serum and BAL galactomannan measures are recommended as markers for the diagnosis of IA. PCR should be considered in conjunction with other diagnostic tests. Pathogen identification to species complex level is strongly recommended for all clinically relevant Aspergillus isolates; antifungal susceptibility testing should be performed in patients with invasive disease in regions with resistance found in contemporary surveillance programmes. Isavuconazole and voriconazole are the preferred agents for first-line treatment of pulmonary IA, whereas liposomal amphotericin B is moderately supported. Combinations of antifungals as primary treatment options are not recommended. Therapeutic drug monitoring is strongly recommended for patients receiving posaconazole suspension or any form of voriconazole for IA treatment, and in refractory disease, where a personalized approach considering reversal of predisposing factors, switching drug class and surgical intervention is also strongly recommended. Primary prophylaxis with posaconazole is strongly recommended in patients with acute myelogenous leukaemia or myelodysplastic syndrome receiving induction chemotherapy. Secondary prophylaxis is strongly recommended in high-risk patients. We strongly recommend treatment duration based on clinical improvement, degree of immunosuppression and response on imaging.

KW - Aspergillosis

KW - Diagnosis

KW - Haematology

KW - Infectious Diseases

KW - Invasive fungal infection

KW - Microbiology (medical)

KW - Transplantation

KW - Treatment

KW - Aspergillosis

KW - Diagnosis

KW - Haematology

KW - Infectious Diseases

KW - Invasive fungal infection

KW - Microbiology (medical)

KW - Transplantation

KW - Treatment

UR - http://hdl.handle.net/10807/116936

UR - http://onlinelibrary.wiley.com/journal/10.1111/(issn)1469-0691

U2 - 10.1016/j.cmi.2018.01.002

DO - 10.1016/j.cmi.2018.01.002

M3 - Article

SN - 1198-743X

VL - 24

SP - e1-e38

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

ER -

Diagnosis and management of Aspergillus diseases: Executive summary of the 2017 ESCMID-ECMM-ERS guideline

Abstract

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Keywords

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