Skip to main content

Table 2 Details of host factors, imaging, and fungal criteria for each patient. Classification as putative or probable invasive pulmonary aspergillosis was done according to AspICU algorithm, as previously published (3), and according the BM-AspICU algorithm proposed in this study

From: New clinical algorithm including fungal biomarkers to better diagnose probable invasive pulmonary aspergillosis in ICU

Patients with EORTC/MSGERC-2008 host factor
  Age Sex EORCT/MSGERC-2008 host factor EORTC/MSGERC-2008 imaging Aspergillus-positive culture GM serum GM BALF Outcome
3 months
AspICU BM-AspICU Mycological criteria
IAPA
Mycological criteria
CAPA
P1 66 M AML Condensation None Pos* (0.98) Not done alive Not sortable Probable Yes Yes
P2 25 M SOT (kidney) Micronodules BALF Pos* (1.05) Not done dead Putative (4a + 4b) Probable Yes Yes
P3 48 F SOT (heart) Nodules, condensations Tracheal aspirate Not done Not done dead Putative (4a) Probable No No
P4 58 F SOT (lung) Opacities Bronchial and pleural aspirates Neg Neg alive Putative (4a) Probable No No
P5 43 M Lymphoma Micronodules, ground glass opacities BALF Neg Neg* alive Putative (4a + 4b) Probable Yes Yes
P6 63 F SOT (liver) Nodules BALF Pos* (2.3) Pos* (0.88) dead Putative (4a + 4b) Probable Yes Yes
P7 49 M Leukemia Nodules, condensations Bronchial aspirate Pos (4) Pos (4) dead Putative (4a) Probable Yes Yes
P8 65 M SOT (heart) Condensation, ground glass opacities BALF tracheal aspirate Pos (1.7) Neg dead Putative (4a + 4b) Probable Yes Yes
P9 65 F Lymphoma ground glass opacities Bronchial aspirate Neg Not done alive Putative (4a) Probable No No
P10 59 M AML Condensation, ground glass opacities None Neg Not done dead Not sortable Not sortable No No
P11 56 M AML Nodules None Not done Not done dead Not sortable Not sortable No No
Patients without EORTC/MSG-2008 host factor
  Age Sex Risk factors Imaging Aspergillus- positive culture GM serum GM BALF Outcome
3 months
AspICU BM-AspICU IAPA criteria CAPA criteria
P12 58 M Chronic alcoholism and massive exposure during demolition work Widespread opacities BALF, tracheal aspirate Pos (3.46) Not done alive Putative (4b) Probable Yes Yes
P13 50 F Basedow and toxic agranulocytosis Condensations BALF, tracheal aspirate Not done Not done dead Putative (4b) Probable Yes Yes
P14 72 F Diabetes Condensations and ground glass opacities BALF, tracheal aspirate Not done Not done dead Putative (4b) Probable Yes Yes
P15 62 M Cardiac surgery Nodular and cavitary lesions BALF, tracheal aspirate Neg Not done dead Putative (4b) Probable Yes Yes
P16 25 M Still’s disease and steroid Pleural effusion BALF Pos (1.8) Negative dead Putative (4b) Probable Yes Yes
P17 68 M Gout attack, steroid ground glass opacities BALF, tracheal aspirate Pos (1.61) Not done dead Putative (4b) Probable Yes Yes
P18 40 M Chronic alcoholism and diabetes Multiple nodules BALF Pos (1.07) Pos (2.66) dead Putative (4b) Probable Yes Yes
P19 70 F Lung cancer Nodules BALF, tracheal aspirate Pos (1.06) Pos (9.5) dead Putative (4b) Probable Yes Yes
P20 75 M COPD, adenocarcinoma Nodules 2 bronchial aspirates Neg Neg dead Not sortable Probable No No
P21 57 F Chronic alcoholism and active smoker Micronodules and condensation Tracheal and bronchial aspirates Pos (1.27) Not done alive Not sortable Probable Yes Yes
P22 58 F Steroid, vasculitis Opacities Tracheal aspirate Pos (5) Not done dead Not sortable Probable Yes Yes
P23 64 M Diabetes, active smoking, drowning in mud while in alcohol-induced coma Diffused opacities, halo sign Tracheal aspirate Pos (3) Not done dead Not sortable Probable Yes Yes
P24 70 M Chronic alcoholism and COPD Abscesses Tracheal aspirate
Pericardial fluid
Not done Not done dead Not sortable Probable No No
P25 69 M Chronic alcoholism and COPD and active smoker Nodule, cavity Pleural fluid Pos (2.5) Not done alive Not sortable Probable Yes Yes
P26 62 M Idiopathic pulmonary fibrosis Ground glass opacities None Neg Not done dead Not sortable Not sortable No No
P27 40 M Chronic alcoholism and Protein S deficiency and active smoker Condensations Bronchial aspiration Pos (1.34) Pos (3.6) dead Not sortable Probable Yes Yes
  1. Mycological criteria proposed in the new case definitions of putative Influenza-associated pulmonary aspergillosis (IAPA) [5] and putative Covid-19 associated pulmonary aspergillosis (CAPA) [6] were also assessed in our series
  2. Requirement for putative IAPA are radiological (any infiltrate) associated to positive culture from BALF, positive GM in BALF (≥ 1.0) or positive GM in serum (≥ 0.5)
  3. Requirement for putative CAPA are nonspecific radiology signs associated with two or more positives across different test types or multiple positives within one test type, from the following (positive culture from BALF, positive GM in BALF (≥ 1.0), positive GM in serum (≥ 0.5), positive qPCR in BALF or blood, positive beta-D glucan in serum/plasma. In case of radiology typical of IA, one positive mycological tests as listed above is sufficient
  4. 4a and 4b refer to criteria 4 from AspICU algorithm, detailed in reference [3]
  5. 4a: host risk factors according to AspICU algorithm: one of the following condition (neutropenia; underlying hematological or oncological malignancy treated with cytotoxic agents; glucocorticoid treatment; congenital or acquired immunodeficiency) as described in reference [3]
  6. 4b: semiquantitative Aspergillus-positive culture of broncho-alveolar lavage fluid (+ or + +), with a positive cytological smear showing branching hyphae
  7. * Positive qPCR on the same sample