Universität zu Köln

Ullmann, A. J., Aguado, J. M., Arikan-Akdagli, S., Denning, D. W., Groll, A. H., Lagrou, K., Lass-Floerl, 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., Bruggemann, R. J. M., Buchheidt, D., Cadranel, J., Castagnola, E., Chakrabarti, A., Cuenca-Estrella, M., Dimopoulos, G., Fortun, J., Gangneux, J. -P., Garbino, J., Heinz, W. J., Herbrecht, R., Heussel, C. P., Kibbler, C. C., Klimko, N., Kullberg, B. J., Lange, C., Lehrnbecher, T., Loeffler, J., Lortholary, O., Maertens, J., Marchetti, O., Meis, J. F., Pagano, L., Ribaud, P., Richardson, M., Roilides, E., Ruhnke, M., Sanguinetti, M., Sheppard, D. C., Sinko, J., Skiada, A., Vehreschild, M. J. G. T., Viscoli, C. and Cornely, O. A. (2018). Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin. Microbiol. Infect., 24. S. E1 - 38. OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

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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 micro-scopy, 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 acutemyelogenous leukaemia ormyelodysplastic 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. (C) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ullmann, A. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Aguado, J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Arikan-Akdagli, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Denning, D. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Groll, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lagrou, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lass-Floerl, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lewis, R. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Munoz, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Verweij, P. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Warris, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ader, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Akova, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Arendrup, M. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barnes, R. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Beigelman-Aubry, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Blot, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bouza, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruggemann, R. J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buchheidt, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cadranel, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Castagnola, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chakrabarti, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cuenca-Estrella, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dimopoulos, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fortun, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gangneux, J. -P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Garbino, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinz, W. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbrecht, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heussel, C. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kibbler, C. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klimko, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kullberg, B. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lange, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehrnbecher, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loeffler, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lortholary, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maertens, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Marchetti, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meis, J. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pagano, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ribaud, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Richardson, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Roilides, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruhnke, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sanguinetti, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sheppard, D. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sinko, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Skiada, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, M. J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Viscoli, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-186811
DOI:	10.1016/j.cmi.2018.01.002
Journal or Publication Title:	Clin. Microbiol. Infect.
Volume:	24
Page Range:	S. E1 - 38
Date:	2018
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1469-0691
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVASIVE PULMONARY ASPERGILLOSIS; LIPOSOMAL AMPHOTERICIN-B; BRONCHOALVEOLAR LAVAGE FLUID; STEM-CELL TRANSPLANTATION; POLYMERASE-CHAIN-REACTION; REAL-TIME PCR; CENTRAL-NERVOUS-SYSTEM; BETA-D-GLUCAN; CRITICALLY-ILL PATIENTS; INTENSIVE-CARE-UNIT Multiple languages Infectious Diseases; Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18681