Publication:
Impact of revised EORTC/MSGERC 2020 criteria on diagnosis and prognosis of invasive pulmonary aspergillosis in patients with hematological malignancies undergoing bronchoscopy

dc.contributor.authorAcet-Öztürk, N. A.
dc.contributor.authorÖmer-Topcu, D.
dc.contributor.authorVurat-Acar, K.
dc.contributor.authorAydın-Güçlü, O.
dc.contributor.authorPınar, I. E.
dc.contributor.authorDemirdoğen, E.
dc.contributor.authorGörek-Dilektaşli, A.
dc.contributor.authorKazak, E.
dc.contributor.authorÖzkocaman, V
dc.contributor.authorUrsavaş, A.
dc.contributor.authorAkalın, H.
dc.contributor.authorÖzkalemkas, F.
dc.contributor.authorEner, B.
dc.contributor.authorAli, R.
dc.contributor.buuauthorACET ÖZTÜRK, NİLÜFER AYLİN
dc.contributor.buuauthorÖMER TOPÇU, DİLARA
dc.contributor.buuauthorVURAT ACAR, KÜBRA
dc.contributor.buuauthorAYDIN GÜÇLÜ, ÖZGE
dc.contributor.buuauthorPINAR, İBRAHİM ETHEM
dc.contributor.buuauthorDEMİRDÖĞEN, EZGİ
dc.contributor.buuauthorGÖREK DİLEKTAŞLI, ASLI
dc.contributor.buuauthorKAZAK, ESRA
dc.contributor.buuauthorÖZKOCAMAN, VİLDAN
dc.contributor.buuauthorURSAVAŞ, AHMET
dc.contributor.buuauthorAKALIN, EMİN HALİS
dc.contributor.buuauthorÖZKALEMKAŞ, FAHİR
dc.contributor.buuauthorENER, BEYZA
dc.contributor.buuauthorALİ, RIDVAN
dc.contributor.departmentTıp Fakültesi
dc.contributor.departmentEnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
dc.contributor.orcid0000-0001-9907-1498
dc.contributor.orcid0000-0002-7380-2501
dc.contributor.researcheridJII-3270-2023
dc.contributor.researcheridFRE-8778-2022
dc.contributor.researcheridGXC-7806-2022
dc.contributor.researcheridGXD-8045-2022
dc.contributor.researcheridJGM-6601-2023
dc.contributor.researcheridJIA-5197-2023
dc.contributor.researcheridCRM-4095-2022
dc.contributor.researcheridCZK-6380-2022
dc.contributor.researcheridJIR-6730-2023
dc.contributor.researcheridAAI-3169-2021
dc.contributor.researcheridEJJ-6847-2022
dc.contributor.researcheridJIW-1248-2023
dc.contributor.researcheridCNK-0895-2022
dc.contributor.researcheridGXD-8209-2022
dc.date.accessioned2024-09-11T13:27:53Z
dc.date.available2024-09-11T13:27:53Z
dc.date.issued2022-06-14
dc.description.abstractIntroduction: The first consensus definitions for invasive fungal diseases (IFD) were published in 2002. Advan-ces in diagnostic tests and a clear need for improvement in certain areas led to a revision of these definitions in 2008. However, growing data on Aspergillus galactomannan (GM) thresholds and the introduction of new polymerase chain reaction-based diagnostic tests resulted in a further update by EORTC and Mycoses Study Group Education and Research Consortium (MSGERC) in 2020. Compared to the 2008 version, the 2020 EORTC/MSGERC criteria have stricter definitions, especially regarding GM levels, which should lead to improved specificity. Thus, our study aimed to evaluate diagnostic changes, based on GM levels, resulting from these new definitions and ascertain the impact of the new classification on mortality rates. Method: Patients hospitalized in a single tertiary care center with hematologic malignancies and undergoing bronchoscopy for suspected IPA between April 2004 and December 2019 were included in this retrospective study. Results: The study population consisted of 327 patients with 31 patients (nine patients with proven IPA and 22 patients with no IPA) excluded from the study. 194 patients were classified as probable IPA cases according to 2008 EORTC/MSG criteria. However, 53 (27.3%) of these patients were re-classified as possible IPA according to 2020 EORTC/MSGERC criteria, due to novel galactomannan cut-off levels. Compared to re-classified possible IPA patients, those remaining in the probable IPA category experienced a higher incidence of septic shock (34.0% vs 16.9%, p=0.02), and required more non-invasive (12.0% vs 0.0%, p=0.004) and invasive (44.6 vs 24.5%, p=0.01) mechanical ventilation. There was a higher in-hospital mortality rate in probable IPA patients than in the re-clas-sified possible IPA group (42.5% vs 22.6%, p=0.01). Patients reassigned to possible IPA had similar underlying dis-eases, radiological features and prognosis to patients already classified as possible IPA. Independent risk factors for mortality were classification as probable IPA according to 2020 EORTC/MSGERC criteria, lack of remission from hematologic malignancy, and number of nodules in Thorax CT. Conclusion: The use of 2020 EORTC/MSGERC criteria resulted in a 27.3% significant reduction in probable IPA diagnoses and created a more homogeneous category of patients with respect to treatment response, prog-nosis and mortality. Therefore, 2020 EORTC/MSGERC criteria afford more reliable mortality prediction than 2008 EORTC/MSG criteria.(c) 2022 SFMM. Published by Elsevier Masson SAS. All rights reserved.
dc.identifier.doi10.1016/j.mycmed.2022.101304
dc.identifier.issn1156-5233
dc.identifier.issue4
dc.identifier.urihttps://doi.org/10.1016/j.mycmed.2022.101304
dc.identifier.urihttps://www.sciencedirect.com/science/article/pii/S1156523322000610?via%3Dihub
dc.identifier.urihttps://hdl.handle.net/11452/44600
dc.identifier.volume32
dc.identifier.wos000862246400006
dc.indexed.wosWOS.SCI
dc.language.isoen
dc.publisherMasson Editeur
dc.relation.journalJournal de Mycologie Medicale
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi
dc.subjectFungal-infections
dc.subjectAmphotericin-b
dc.subjectEuropean organization
dc.subject2008 definitions
dc.subjectDiseases
dc.subjectVoriconazole
dc.subjectTherapy
dc.subjectTrial
dc.subjectInvasive pulmonary aspergillosis
dc.subjectDiagnostic criteria
dc.subjectGalactomannan
dc.subjectMycology
dc.titleImpact of revised EORTC/MSGERC 2020 criteria on diagnosis and prognosis of invasive pulmonary aspergillosis in patients with hematological malignancies undergoing bronchoscopy
dc.typeArticle
dspace.entity.typePublication
local.contributor.departmentTıp Fakültesi/Göğüs Hastalıkları Ana Bilim Dalı
local.contributor.departmentTıp Fakültesi/İç Hastalıkları Ana Bilim Dalı
local.contributor.departmentTıp Fakültesi/Hematoloji Ana Bilim Dalı
local.contributor.departmentTıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
local.contributor.departmentTıp Fakültesi/Mikrobiyoloji Ana Bilim Dalı
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