{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T23:08:34Z","timestamp":1779232114796,"version":"3.51.4"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background.<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Aspergillus<\/jats:italic>\n                      spp. and other mold infections are the most common fungal infections in lung transplant recipients (LTRs). There is no established antifungal preventive strategy for LTR; however, lifelong nebulized liposomal amphotericin B (n-LAB) prophylaxis has been used in our center. This study evaluated breakthrough mold infections (b-MIs) and the tolerability of n-LAB prophylaxis in a LTR cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>This observational retrospective study included all consecutive adult LTR who received n-LAB prophylaxis between August 2013 and March 2023. Participants were followed up for at least 1-y posttransplant unless they died earlier. Only proven and probable mold infections during n-LAB exposure were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Among 802 LTR (median age, 57.8 y; 41.9% female), 821 transplants were performed. The incidence of b-MI within the first year posttransplantation was 8.7%. Over a median follow-up of 2.56 y (interquartile range, 1.01\u20135.25 y), 94 LTR (11.7%) developed b-MI, comprising 111 episodes of infection. Independent risk factors for b-MI included bronchial stenosis, bronchial stent placement, and single lung transplant. Prophylaxis with n-LAB was well tolerated, with discontinuation owing to adverse events occurring in only 18 participants (2.2%). Mold colonization and b-MI were both associated with an increased risk of death (adjusted hazard ratio, 5.38; 95% confidence interval, 3.24-8.94 and adjusted hazard ratio, 14.07; 95% confidence interval, 8.50-23.28, respectively). No difference in mortality was observed between the amphotericin B-nonsusceptible isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>Lifelong n-LAB prophylaxis was associated with a low incidence of mold infection during prolonged follow-up and maintained excellent tolerability. The emergence of amphotericin B-nonsusceptible molds was not associated with increased mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/tp.0000000000005686","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T04:00:18Z","timestamp":1775620818000},"page":"e1141-e1151","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Breakthrough Mold Infections During Long-term Nebulized Liposomal Amphotericin B Prophylaxis in Lung Transplant Recipients: A Single-center Cohort (NEBULA Study)"],"prefix":"10.1097","volume":"110","author":[{"given":"Arnau","family":"Monforte","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibai","family":"Los-Arcos","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain."},{"name":"CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Mart\u00edn-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Microbiology Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, 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Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Hospital Campus, Barcelona, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Rosado","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Falc\u00f3-Roget","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo","family":"Escudero","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Casanovas","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Kirkegaard-Biosca","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berta","family":"S\u00e1ez-Gim\u00e9nez","sequence":"additional","affiliation":[{"name":"Pneumology Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."},{"name":"CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Monforte","sequence":"additional","affiliation":[{"name":"Pneumology Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."},{"name":"CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Gavald\u00e0","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."},{"name":"CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar","family":"Len","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Research Institute (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, Barcelona, Spain."},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain."},{"name":"CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"R1-20260519","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1086\/651262","article-title":"Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET).","volume":"50","author":"Pappas","year":"2010","journal-title":"Clin 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