{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:19:32Z","timestamp":1788308372117,"version":"build-2803163510"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>International consensus definitions for invasive aspergillosis (IA) in research are rigorous, yet clinically significant cases are often excluded from clinical studies for not meeting proven\/probable IA case definitions. To better understand reasons for the failure to meet criteria for proven\/probable infection, we herein review 47 such cases for their clinical and microbiological characteristics and outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on 47 cases that did not meet consensus IA definitions but were deemed significant were derived from a retrospective, observational, multicenter survey of 382 presumed IA cases across Australasia, of which findings of 221 proven\/probable infections were recently published. The clinical, microbiological, and radiologic characteristics of these cases were analyzed. Mortality outcomes were compared with those of 221 proven\/probable cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 47 cases studied, 15 lacked classical host factors; 22 exhibited only a single positive Aspergillus polymerase chain reaction result; 7 lacked typical IA radiologic findings on chest computed tomography; and 3 had borderline galactomannan optical density indices (&amp;lt;1.0 but \u22650.5) in bronchoalveolar lavage fluid. The median age of patients was 61 years (IQR, 52\u201368); 34 were male (72%). Seven patients (15%) required intensive care admission. All patients had lung as the primary site of infection. Antifungal treatment was initiated in 42 patients (89%). All-cause 90-day mortality was 33%, similar to the 30% mortality in the comparative cohort (n = 221).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings highlight the limitations of current consensus definitions for IA. Notably, the mortality of patients not meeting these definitions was similar to that of patients with proven\/probable IA. Further studies, especially of patients with a single positive Aspergillus polymerase chain reaction result and those without host factors, are needed to determine if future consensus definitions may benefit from modifications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae594","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T17:56:21Z","timestamp":1728496581000},"source":"Crossref","is-referenced-by-count":7,"title":["Identifying Gaps in the International Consensus Case Definitions for Invasive Aspergillosis: A Review of Clinical Cases Not Meeting These Definitions"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2774-2237","authenticated-orcid":false,"given":"Shio Yen","family":"Tio","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer , Melbourne ,","place":["Australia"]},{"name":"Department of Infectious Diseases, Royal Melbourne Hospital , Melbourne ,","place":["Australia"]},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-6603","authenticated-orcid":false,"given":"Sharon C A","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital , Sydney ,","place":["Australia"]},{"name":"School of Medicine, University of Sydney , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7850-6931","authenticated-orcid":false,"given":"Christopher H","family":"Heath","sequence":"additional","affiliation":[{"name":"Department of Microbiology, PathWest Laboratory Medicine , Murdoch ,","place":["Australia"]},{"name":"Department of Infectious Diseases, Fiona Stanley Hospital , Murdoch ,","place":["Australia"]},{"name":"Department of Medicine, University of Western Australia , Crawley ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9499-0292","authenticated-orcid":false,"given":"Alyssa","family":"Pradhan","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Sydney , New South Wales ,","place":["Australia"]},{"name":"Department of Infectious Diseases and Microbiology, Royal Prince Alfred Hospital , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur J","family":"Morris","sequence":"additional","affiliation":[{"name":"Auckland City Hospital , Auckland ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6155-8353","authenticated-orcid":false,"given":"Tony M","family":"Korman","sequence":"additional","affiliation":[{"name":"Monash University and Monash Health , Clayton ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Orla","family":"Morrissey","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Alfred Health and Monash University , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona L","family":"Halliday","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital , Sydney ,","place":["Australia"]},{"name":"School of Medicine, University of Sydney , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5957-4178","authenticated-orcid":false,"given":"Sarah","family":"Kidd","sequence":"additional","affiliation":[{"name":"National Mycology Reference Centre, Microbiology and Infectious Diseases, South Australia Pathology , Adelaide ,","place":["Australia"]},{"name":"School of Biological Sciences, Faculty of Science Engineering & Technology, University of Adelaide , Adelaide ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Spelman","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Peter MacCallum Cancer Centre , Melbourne ,","place":["Australia"]},{"name":"Department of Clinical Neuroscience, Karolinska Institute , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4543-5373","authenticated-orcid":false,"given":"Nadiya","family":"Brell","sequence":"additional","affiliation":[{"name":"The Wollongong Hospital , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"McMullan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sydney Children's Hospital , Randwick ,","place":["Australia"]},{"name":"School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales (UNSW) , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia E","family":"Clark","sequence":"additional","affiliation":[{"name":"Infection Management Service, Queensland Children's Hospital, Children's Health Queensland , Brisbane ,","place":["Australia"]},{"name":"School of Clinical Medicine, Childrens Health Queensland Clinical Unit, University of Queensland , Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Mitsakos","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Microbiology, Royal North Shore Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn P","family":"Hardiman","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Microbiology, Royal North Shore Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoebe C M","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sydney Children's Hospital , Randwick ,","place":["Australia"]},{"name":"School of Public Health, Faculty of Medicine, The University of Sydney , New South Wales ,","place":["Australia"]},{"name":"University of Sydney Infectious Diseases Institute , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5898-1126","authenticated-orcid":false,"given":"Anita J","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Perth Children's Hospital , Western Australia ,","place":["Australia"]},{"name":"Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia , Western Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1978-1559","authenticated-orcid":false,"given":"Justin","family":"Beardsley","sequence":"additional","affiliation":[{"name":"University of Sydney Infectious Diseases Institute , New South Wales ,","place":["Australia"]},{"name":"Westmead Hospital, Western Sydney Local Health District, NSW Health , New South Wales ,","place":["Australia"]},{"name":"Westmead Institute for Medical Research , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5852-4155","authenticated-orcid":false,"given":"Sebastiaan","family":"Van Hal","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Sydney , New South Wales ,","place":["Australia"]},{"name":"Department of Infectious Diseases and Microbiology, Royal Prince Alfred Hospital , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle K","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer , Melbourne ,","place":["Australia"]},{"name":"Department of Infectious Diseases, Royal Melbourne Hospital , Melbourne ,","place":["Australia"]},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon J","family":"Worth","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer , Melbourne ,","place":["Australia"]},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8443-314X","authenticated-orcid":false,"given":"Monica A","family":"Slavin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne ,","place":["Australia"]},{"name":"National Centre for Infections in Cancer , Melbourne ,","place":["Australia"]},{"name":"Department of Infectious Diseases, Royal Melbourne Hospital , Melbourne ,","place":["Australia"]},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"2024112610431873600_ofae594-B1","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","article-title":"Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium","volume":"71","author":"Donnelly","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2024112610431873600_ofae594-B2","first-page":"100888","article-title":"Invasive aspergillosis in adult patients in Australia and New Zealand: 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