{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:03:56Z","timestamp":1790888636323,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":3,"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":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Available data on combat wound\u2010related invasive mould infections (IMIs) are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to describe the characteristics and outcomes of IMIs in casualties of a recent conflict.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Methods<\/jats:title>\n                    <jats:p>A retrospective study including hospitalised patients with combat\u2010related injuries, fulfilling criteria for wound\u2010related IMI based on Trauma Infectious Disease Outcomes Study definitions. Patient and injury characteristics, management and outcomes are described and compared to previous cohorts. Mould isolates and susceptibility testing results, including the novel agent manogepix, are reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 31 patients (69 mould isolates) were included\u2014resulting in an IMI incidence rate of 1.9%. Blast was the most common injury mechanism (71%), with limb amputations and abdominoperineal injuries in 35% and 45%, respectively. Mould cultures, obtained mostly from lower extremities wounds (62%), were positive in all patients. Most (68%) had poly\u2010mould infections, with\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      and\n                      <jats:italic>Fusarium<\/jats:italic>\n                      species predominating. Overall, non\u2010susceptibility rates of &gt;\u200950% to newer azoles and 38% to amphotericin B reflected the high proportion of\n                      <jats:italic>Fusarium<\/jats:italic>\n                      spp.,\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>A. terreus<\/jats:italic>\n                      <\/jats:styled-content>\n                      and\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">A. flavus<\/jats:styled-content>\n                        ,\n                      <\/jats:italic>\n                      with the lowest azole minimal inhibitory concentrations demonstrated with posaconazole. Manogepix displayed good in\u2010vitro activity against all isolates, except for Mucorales species. Two patients (6.5%) died of disseminated IMIs and 19% required amputations. Patients with Mucorales had poorer outcomes (40% mortality\/amputation vs. 19% for non\u2010Mucorales).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combat wound\u2010related IMIs are uncommon but carry significant morbidity and mortality. High susceptibility rates to manogepix were observed. Further studies are needed to evaluate optimal surgical approaches and the role of antifungal susceptibility testing in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.70028","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T06:43:36Z","timestamp":1738651416000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Invasive Mould Infections Following Combat\u2010Related Injuries\u2014A Retrospective Cohort Study"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3535-6835","authenticated-orcid":false,"given":"Tomer","family":"Hoffman","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit Sheba Medical Center  Ramat\u2010Gan Israel"},{"name":"Faculty of Medicine &amp; Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Haviv","sequence":"additional","affiliation":[{"name":"Faculty of Medicine &amp; Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"General Intensive Care Unit Sheba Medical Center  Ramat\u2010Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Cohen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine &amp; Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"General Intensive Care Unit Sheba Medical Center  Ramat\u2010Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1230-0428","authenticated-orcid":false,"given":"Lior","family":"Nesher","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute Soroka University Medical Center  Beer Sheba Israel"},{"name":"The Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tal","family":"Schlaeffer\u2010Yosef","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute Soroka University Medical Center  Beer Sheba Israel"},{"name":"The Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hovav","family":"Azulay","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute Soroka University Medical Center  Beer Sheba Israel"},{"name":"The Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7154-2032","authenticated-orcid":false,"given":"Tal","family":"Brosh\u2010Nissimov","sequence":"additional","affiliation":[{"name":"The Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheba Israel"},{"name":"Infectious Diseases Unit Assuta Ashdod University Hospital  Ashdod Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Amit","sequence":"additional","affiliation":[{"name":"Faculty of Medicine &amp; Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Clinical Microbiology Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeala","family":"Gazit","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Tribble","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronen","family":"Ben\u2010Ami","sequence":"additional","affiliation":[{"name":"Faculty of Medicine &amp; Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Infectious Disease Unit Tel Aviv Sourasky Medical Center  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dafna","family":"Yahav","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit Sheba Medical Center  Ramat\u2010Gan Israel"},{"name":"Faculty of Medicine &amp; Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12281-020-00385-4"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2017.07.002"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usab074"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S095026881400051X"},{"key":"e_1_2_9_6_1","unstructured":"C. O. L. R.Ressner D. R.Tribble C. K.Murray et\u00a0al. \u201cJoint Trauma System Clinical Practice Guideline (JTS CPG) Invasive Fungal Infection in War Wounds \u201d 2023."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis749"},{"key":"e_1_2_9_8_1","unstructured":"\u201cIDF Casualties \u201d Dashboard accessed July 31 2024 https:\/\/www.idf.il."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2509.190168"},{"key":"e_1_2_9_10_1","volume-title":"Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi","author":"CLSI","year":"2017"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2021.04.012"},{"key":"e_1_2_9_12_1","unstructured":"Israeli Ministry of Health \u201cIron Swords \u201d Dashboard accessed December 21 2024 https:\/\/datadashboard.health.gov.il\/portal\/dashboard\/health."},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12281-014-0205-y"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000768"},{"key":"e_1_2_9_15_1","unstructured":"The IDF Stunned NATO: A World Record in Rescuing the Wounded.The \u201cmedical secret\u201d has been revealed.(2024) accessed September 3 2024 https:\/\/www.ynet.co.il\/health\/article\/yokra13877090."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2013.123"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2012.245"},{"key":"e_1_2_9_18_1","article-title":"Molecular Detection of Filamentous Fungi in Formalin\u2010Fixed Paraffin\u2010Embedded Specimens in Invasive Fungal Wound Infections Is Feasible With High Specificity","volume":"58","author":"Ganesan A.","year":"2020","journal-title":"Journal of Clinical Microbiology"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00835-15"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000447"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1008"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.70028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T23:31:06Z","timestamp":1741735866000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.70028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/myc.70028"],"URL":"https:\/\/doi.org\/10.1111\/myc.70028","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-11-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70028"}}