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This retrospective study revealed a 9% incidence of influenza-associated pulmonary aspergillosis (IAPA) in ICU-admitted influenza patients, emphasizing the importance of screening protocols for early diagnosis and treatment, with ICU mortality significantly higher among IAPA patients compared to non-IAPA patients.

The following is a summary of “Influenza-associated invasive aspergillosis in patients admitted to the intensive care unit in Sweden: a prospective multicentre cohort study,” published in the December 2023 issue of Infectious Diseases by Krifors et al.

Researchers conducted a retrospective study to investigate influenza-associated pulmonary aspergillosis (IAPA) incidence in ICU-admitted influenza patients.

They enrolled consecutive adult patients with PCR-confirmed influenza A or B across 12 ICUs spanning four influenza seasons (2019-2023). Participants underwent screening via serum galactomannan and β-d-glucan tests, along with fungal culture of respiratory samples upon admission and weekly throughout their ICU stay. Bronchoalveolar lavage was conducted when clinically feasible. Classification of IAPA followed recently introduced case definitions.

The results showed that out % of the 55 patients, 42% were female, with a median age of 59 years (IQR 48-71). Every patient underwent galactomannan testing, β-d-glucan testing, and respiratory culture. Bronchoalveolar lavage was conducted in 24 (44%) of the patients. Five patients (9%, 95% CI 3.8% – 20.4%) were classified as probable IAPA, with four lacking classical risk factors. ICU mortality was significantly higher among IAPA patients compared to non-IAPA patients (60% vs 8%, P=0.01).

Investigators concluded that a study confirmed a 9% IAPA incidence in ICU influenza patients underscores the need for IAPA screening protocols to improve early diagnosis and treatment.

Source: tandfonline.com/doi/full/10.1080/23744235.2023.2273381