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Aspergillus fumigatus-a systematic review to inform the World Health Organization priority list of fungal pathogens.

Publication ,  Journal Article
Morrissey, CO; Kim, HY; Duong, T-MN; Moran, E; Alastruey-Izquierdo, A; Denning, DW; Perfect, JR; Nucci, M; Chakrabarti, A; Rickerts, V; Sati, H ...
Published in: Med Mycol
June 27, 2024

Recognizing the growing global burden of fungal infections, the World Health Organization established a process to develop a priority list of fungal pathogens (FPPL). In this systematic review, we aimed to evaluate the epidemiology and impact of invasive infections caused by Aspergillus fumigatus to inform the first FPPL. The pre-specified criteria of mortality, inpatient care, complications and sequelae, antifungal susceptibility, risk factors, preventability, annual incidence, global distribution, and emergence were used to search for relevant articles between 1 January 2016 and 10 June 2021. Overall, 49 studies were eligible for inclusion. Azole antifungal susceptibility varied according to geographical regions. Voriconazole susceptibility rates of 22.2% were reported from the Netherlands, whereas in Brazil, Korea, India, China, and the UK, voriconazole susceptibility rates were 76%, 94.7%, 96.9%, 98.6%, and 99.7%, respectively. Cross-resistance was common with 85%, 92.8%, and 100% of voriconazole-resistant A. fumigatus isolates also resistant to itraconazole, posaconazole, and isavuconazole, respectively. The incidence of invasive aspergillosis (IA) in patients with acute leukemia was estimated at 5.84/100 patients. Six-week mortality rates in IA cases ranged from 31% to 36%. Azole resistance and hematological malignancy were poor prognostic factors. Twelve-week mortality rates were significantly higher in voriconazole-resistant than in voriconazole-susceptible IA cases (12/22 [54.5%] vs. 27/88 [30.7%]; P = .035), and hematology patients with IA had significantly higher mortality rates compared with solid-malignancy cases who had IA (65/217 [30%] vs. 14/78 [18%]; P = .04). Carefully designed surveillance studies linking laboratory and clinical data are required to better inform future FPPL.

Duke Scholars

Published In

Med Mycol

DOI

EISSN

1460-2709

Publication Date

June 27, 2024

Volume

62

Issue

6

Location

England

Related Subject Headings

  • World Health Organization
  • Voriconazole
  • Risk Factors
  • Microbiology
  • Microbial Sensitivity Tests
  • Invasive Fungal Infections
  • Incidence
  • Humans
  • Drug Resistance, Fungal
  • Aspergillus fumigatus
 

Citation

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Morrissey, C. O., Kim, H. Y., Duong, T.-M., Moran, E., Alastruey-Izquierdo, A., Denning, D. W., … Beardsley, J. (2024). Aspergillus fumigatus-a systematic review to inform the World Health Organization priority list of fungal pathogens. Med Mycol, 62(6). https://doi.org/10.1093/mmy/myad129
Morrissey, C Orla, Hannah Y. Kim, Tra-My N. Duong, Eric Moran, Ana Alastruey-Izquierdo, David W. Denning, John R. Perfect, et al. “Aspergillus fumigatus-a systematic review to inform the World Health Organization priority list of fungal pathogens.Med Mycol 62, no. 6 (June 27, 2024). https://doi.org/10.1093/mmy/myad129.
Morrissey CO, Kim HY, Duong T-MN, Moran E, Alastruey-Izquierdo A, Denning DW, et al. Aspergillus fumigatus-a systematic review to inform the World Health Organization priority list of fungal pathogens. Med Mycol. 2024 Jun 27;62(6).
Morrissey, C. Orla, et al. “Aspergillus fumigatus-a systematic review to inform the World Health Organization priority list of fungal pathogens.Med Mycol, vol. 62, no. 6, June 2024. Pubmed, doi:10.1093/mmy/myad129.
Morrissey CO, Kim HY, Duong T-MN, Moran E, Alastruey-Izquierdo A, Denning DW, Perfect JR, Nucci M, Chakrabarti A, Rickerts V, Chiller TM, Wahyuningsih R, Hamers RL, Cassini A, Gigante V, Sati H, Alffenaar J-W, Beardsley J. Aspergillus fumigatus-a systematic review to inform the World Health Organization priority list of fungal pathogens. Med Mycol. 2024 Jun 27;62(6).
Journal cover image

Published In

Med Mycol

DOI

EISSN

1460-2709

Publication Date

June 27, 2024

Volume

62

Issue

6

Location

England

Related Subject Headings

  • World Health Organization
  • Voriconazole
  • Risk Factors
  • Microbiology
  • Microbial Sensitivity Tests
  • Invasive Fungal Infections
  • Incidence
  • Humans
  • Drug Resistance, Fungal
  • Aspergillus fumigatus