{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:16:09Z","timestamp":1789802169181,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,10,24]],"date-time":"2018-10-24T00:00:00Z","timestamp":1540339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To study the prevalence, risk factors, role of serum biomarkers for diagnosis and impact of invasive fungal infections (IFIs) in patients with acute\u2010on\u2010chronic liver failure (ACLF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An analysis of IFI in patients with ACLF (EASL criteria) was conducted retrospectively. The diagnosis of IFI in clinically suspected patients was based on EORTC\/MSG criteria. The demographical, clinical, laboratory details and outcomes were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 264 patients with ACLF, 54 (20.4%) patients with suspicion of IFI were evaluated and IFI was diagnosed in 39 (14.7%). Invasive candidiasis was documented in 25 (64.1%) and invasive aspergillosis in 14 (35.8%). The most common source of infection was respiratory (n\u00a0=\u00a013) followed by renal (n\u00a0=\u00a07) and spontaneous fungal peritonitis (n\u00a0=\u00a06). On univariate analysis, diabetes mellitus, hemodialysis, prior antibiotic use, cerebral and respiratory organ failures, Chronic Liver Failure Consortium (CLIF\u2010OF and CLIF\u2010C ACLF) scores were predictors for development of IFI (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). On multivariate analysis, hemodialysis and prior antibiotics use predicted the development of IFI (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). Non\u2010survivors were more likely to have IFI (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.029), high CLIF\u2010OF and CLIF\u2010C ACLF scores (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; for both) and higher 1,3\u2010\u03b2 D Glucan (BDG) levels (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.009). The sensitivity, specificity, and AUROC of BDG (80\u00a0pg\/mL) and Galactomannan index (GMI [0.5]) for diagnosing IFI were 97.4%, 60%, 0.770% and 43.6%, 100%, 0.745 respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Invasive fungal infections constitutes an important cause of mortality in ACLF patients. BDG and GMI can be useful markers to guide antifungal therapy in patients at high risk for IFI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13981","type":"journal-article","created":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T00:50:17Z","timestamp":1538441417000},"page":"503-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Invasive fungal infections amongst patients with acute\u2010on\u2010chronic liver failure at high risk for fungal infections"],"prefix":"10.1111","volume":"39","author":[{"given":"Nipun","family":"Verma","sequence":"first","affiliation":[{"name":"Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Postgraduate Institute of Medical Education and Research Chandigarh 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