{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:19:16Z","timestamp":1787818756716,"version":"build-2784847793"},"reference-count":80,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fungal Infection Trust"},{"name":"University of Manchester campus"},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100030679","name":"Mundipharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030679","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014653","name":"Manchester Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203308"],"award-info":[{"award-number":["NIHR203308"]}],"id":[{"id":"10.13039\/100014653","id-type":"DOI","asserted-by":"publisher"}]},{"name":"North West Lung Centre","award":["NW25\/027"],"award-info":[{"award-number":["NW25\/027"]}]},{"name":"North West Lung Centre","award":["NW25\/028"],"award-info":[{"award-number":["NW25\/028"]}]},{"name":"North West Lung Centre","award":["LT092"],"award-info":[{"award-number":["LT092"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>More than 400 million people have chronic obstructive pulmonary disease (COPD), with exacerbations representing a major health burden. Although the overall incidence of invasive pulmonary aspergillosis (IPA) in patients with COPD with hospitalized exacerbation is only 1% to 4%, certain factors substantially increase this frequency. Risk factors compromising defenses against Aspergillus spp. in COPD patients include systemic or high-dose inhaled corticosteroids; comorbidities including bronchiectasis, diabetes, and cardiovascular disease; and prolonged courses of antibiotics. An international group of experts met to develop criteria for diagnosing IPA based on existing literature and consensus in nonventilated COPD patients. The preliminary diagnostic recommendations were further evaluated by additional experts using the Delphi methodology. A hospitalized exacerbation of COPD with 2 or more of the above clinical risk factors should prompt (1) a computed tomography scan of the chest; (2) sending a respiratory sample (sputum, induced sputum or bronchoscopy sample) for direct microscopy for fungi, high-volume fungal culture, and preferably Aspergillus PCR and, if a bronchoscopy sample is obtained, then also Aspergillus antigen (galactomannan); and (3) a serum sample for galactomannan and Aspergillus IgG. The combination of a high-risk COPD patient, with compatible imaging abnormalities and any 2 positive tests (2 samples or different tests on the same respiratory sample) for Aspergillus is sufficient to establish the diagnosis of IPA with enough confidence to initiate antifungal therapy and\/or enroll the patient in a clinical or epidemiological study of IPA in COPD. Additional studies are required to augment performance data for most assays in COPD and validate the proposed diagnostic criteria.<\/jats:p>","DOI":"10.1093\/ajrccm\/aamag310","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:28:04Z","timestamp":1782858484000},"page":"1913-1928","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic criteria for invasive pulmonary aspergillosis in chronic obstructive pulmonary disease patients"],"prefix":"10.1093","volume":"212","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-2251","authenticated-orcid":false,"given":"David W","family":"Denning","sequence":"first","affiliation":[{"name":"Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre , Manchester,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas 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