{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T20:41:32Z","timestamp":1778704892660,"version":"3.51.4"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:00:00Z","timestamp":1644364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:label\/>\n                  <jats:p>Invasive aspergillosis (IA) remains a common cause of mortality in pediatric immunocompromised populations. Much of our knowledge of IA stems from adult literature. We conducted a retrospective evaluation of cases of proven or probable IA, defined according to the 2019 EORTC\/MSG criteria, in patients with underlying immunocompromising conditions at Boston Children's Hospital from January 1, 2007 to January 1, 2019. We estimated survival curves over 12 weeks using the Kaplan-Meier method for all-cause mortality, and we used univariate Cox proportional hazards modeling to evaluate for mortality risk factors. We identified 59 cases, 29% with proven and 71% with probable IA. Pulmonary IA was the most common presentation (78%). The median age at diagnosis was 11 years (range, 0.5\u201328). Hematopoietic cell transplantation (HCT) was the most frequent predisposing underlying condition (41%). Among affected patients, 44.8% were neutropenic and 59.3% were lymphopenic at diagnosis. The 12-week all-cause mortality rate was 25.4%; HCT recipients comprised the majority of deaths (9\/15) with a hazard ratio of 2.47 [95% CI, 0.87\u20136.95]. No patients with congenital immunodeficiencies (n\u00a0=\u00a08) died within 12 weeks of IA diagnosis. Other risk factors that were significantly associated with mortality included mechanical ventilation at diagnosis, intensive care unit stay, and lymphopenia; treatment with an Aspergillus-active azole was associated with decreased mortality.<\/jats:p>\n                  <jats:p>In conclusion, our study found that in pediatric immunocompromised hosts, IA is associated with a high 12-week all-cause mortality rate, with a particular impact on the HCT population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Lay abstract<\/jats:title>\n                  <jats:p>This study explores the epidemiology, outcomes and predictors of mortality of invasive aspergillosis (IA) at a high-volume pediatric center for immunocompromised hosts. Much of our understanding of pediatric IA is extrapolated from the adult literature. Our study found that IA is associated with a high 12-week all-cause mortality rate, with a particular impact on the hematopoietic cell transplantation study cohort.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/mmy\/myac014","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T12:09:52Z","timestamp":1644235792000},"source":"Crossref","is-referenced-by-count":11,"title":["Epidemiology and outcomes of invasive aspergillosis among pediatric immunocompromised patients: A 12-year single-center experience"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5412-6157","authenticated-orcid":false,"given":"Fatima","family":"Al Dhaheri","sequence":"first","affiliation":[{"name":"Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, 15551, Al Ain, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose A","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Pediatrics, Boston Children's Hospital, Boston, USA"},{"name":"Harvard Medical School, Boston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanvi S","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Pediatrics, Boston Children's Hospital, Boston, USA"},{"name":"Harvard Medical School, Boston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mari M","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Pediatrics, Boston Children's Hospital, Boston, USA"},{"name":"Harvard Medical School, Boston, USA"},{"name":"Antimicrobial Stewardship Program, Boston Children's Hospital, Boston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco M","family":"Marty","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, USA"},{"name":"Division of Infectious Diseases, Brigham and Women's Hospital and Dana-Farber Cancer Institute, 02115, Boston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,2,9]]},"reference":[{"key":"2022031210502133000_bib1","doi-asserted-by":"crossref","first-page":"e711","DOI":"10.1542\/peds.2005-1161","article-title":"Epidemiology, outcomes, and costs of invasive aspergillosis in immunocompromised children in the United States, 2000","volume":"117","author":"Zaoutis","year":"2006","journal-title":"Pediatrics"},{"key":"2022031210502133000_bib2","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1056\/NEJMra0808853","article-title":"Aspergillosis","volume":"360","author":"Segal","year":"2009","journal-title":"Review Article N Engl J Med"},{"key":"2022031210502133000_bib3","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1111\/j.1469-0691.2010.03288.x","article-title":"Epidemiology of invasive fungal infections in neonates and children","volume":"16","author":"Steinbach","year":"2010","journal-title":"Clin Microbiol Infect"},{"key":"2022031210502133000_bib4","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1086\/318483","article-title":"Aspergillosis case-fatality rate: systematic review of the literature","volume":"32","author":"Lin","year":"2001","journal-title":"Clin Infect Dis"},{"key":"2022031210502133000_bib5","doi-asserted-by":"crossref","first-page":"e1286","DOI":"10.1542\/peds.2007-2117","article-title":"Pediatric invasive aspergillosis: a multicenter retrospective analysis of 139 contemporary cases","volume":"121","author":"Burgos","year":"2008","journal-title":"Pediatrics"},{"key":"2022031210502133000_bib6","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1086\/588660","article-title":"European Organization for Research and Treatment of Cancer\/Invasive Fungal Infections Cooperative Group; National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC\/MSG) consensus group. 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