{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:32:51Z","timestamp":1761989571618,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A high prevalence of COVID\u201019 associated pulmonary aspergillosis (CAPA) has been reported, though histopathological evidence is frequently lacking. To assess the clinical significance of <jats:italic>Aspergillus<\/jats:italic> species in respiratory samples of mechanically ventilated COVID\u201019 patients, we implemented routine screening for <jats:italic>Aspergillus<\/jats:italic> in tracheal aspirate (TA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/methods<\/jats:title><jats:p>From all adult COVID\u201019 patients admitted to the intensive care unit (ICU), TA samples were collected twice a week for <jats:italic>Aspergillus<\/jats:italic> screening by PCR and or culture. Bronchoalveolar lavage (BAL) sampling was performed in patients with a positive screening result if possible. Clinical information was obtained from the electronic patient record and patients were categorised according to the recently published consensus case definition for CAPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our study population consisted of 63 predominantly (73%) male patients, with a median age of 62\u00a0years and total median ICU stay of 18\u00a0days. <jats:italic>Aspergillus<\/jats:italic> species were present in TA screening samples from 15 patients (24%), and probable CAPA was diagnosed in 11 (17%) patients. Triazole resistance was detected in one patient (14%). Concordance between TA and BAL was 86%, and all TA culture positives were confirmed in BAL. We were able to withhold treatment in three of fifteen patients with positive screening (20%) but negative BAL results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Positive culture, molecular detection and or antigen detection of <jats:italic>Aspergillus<\/jats:italic> species do not equal infection. Until we understand the clinical relevance of <jats:italic>Aspergillus<\/jats:italic> species detected in respiratory samples of COVID\u201019 patients, minimal\u2010invasive screening by TA is a feasible method to monitor patients. Positive screening results should be an indication to perform a BAL to rule out upper airway colonisation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13259","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T15:19:18Z","timestamp":1613747958000},"page":"641-650","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Systematic screening for COVID\u201019 associated invasive aspergillosis in ICU patients by culture and PCR on tracheal aspirate"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4091-2955","authenticated-orcid":false,"given":"Rebecca","family":"van Grootveld","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology Leiden University Medical Center (LUMC) Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"van Paassen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care LUMC Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark G.J.","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases LUMC Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric C.J.","family":"Claas","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Leiden University Medical Center (LUMC) Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ed J.","family":"Kuijper","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology LUMC &amp; Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance National Institute for Public Health and the Environment Bilthoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha T.","family":"van der 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