{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T22:50:57Z","timestamp":1792363857764,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100022752","name":"MSD Sharp and Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100022752","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Posaconazole (POS) prophylaxis is recommended for the prevention of invasive mould infections among patients with haematologic cancer and prolonged neutropenia or following allogeneic haematopoietic cell transplantation. Albeit rare, breakthrough invasive mould infections (bIMI) are associated with high mortality rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the epidemiology, causes and outcomes of bIMI under POS prophylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Methods<\/jats:title>\n                    <jats:p>Haematologic cancer patients with a diagnosis of proven\/probable bIMI while receiving POS prophylaxis for \u2265\u20097\u2009days were retrospectively included in five hospitals (Switzerland and Germany). For each bIMI case, one to two non\u2010bIMI controls receiving POS prophylaxis for the same haematologic condition were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 29 bIMI episodes and 46 controls were included. Baseline characteristics and median POS trough concentrations did not significantly differ between the two groups. Invasive aspergillosis was the most frequent bIMI (52%), followed by invasive mucormycosis (31%). POS non\u2010susceptible pathogens were the causes of bIMI in 14% of cases. While insufficient POS exposure was observed in 39% of bIMI cases, this proportion was similar in the control group. Most bIMI were treated with liposomal amphotericin B first\u2010line therapy and received multiple antifungal therapies. Overall mortality was significantly higher among bIMI compared to controls (52% vs. 20%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Surgery was the only parameter significantly associated with survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case\u2013control study shows that bIMI is associated with a significant impact on mortality. Most bIMI were attributed to presumably POS\u2010susceptible pathogens without a clear association with POS underexposure. The causes of bIMI remain unclear and may be the conjunction of multiple parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.70123","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:38:43Z","timestamp":1760557123000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Breakthrough Invasive Mould Infections Under Posaconazole Prophylaxis in Patients With Haematologic Malignancies: A Case\u2013Control Study"],"prefix":"10.1111","volume":"68","author":[{"given":"Camille","family":"Marchetti","sequence":"first","affiliation":[{"name":"Infectious Diseases Service, Department of Medicine Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Glampedakis","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Department of Medicine Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9152-2469","authenticated-orcid":false,"given":"Jannik","family":"Stemler","sequence":"additional","affiliation":[{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"},{"name":"Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Faculty of Medicine, and University Hospital Cologne University of Cologne  Cologne Germany"},{"name":"German Centre for Infection Research (DZIF) Partner Site Bonn\u2010Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luise","family":"H\u00e4nsel","sequence":"additional","affiliation":[{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"},{"name":"Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Faculty of Medicine, and University Hospital Cologne University of Cologne  Cologne Germany"},{"name":"German Centre for Infection Research (DZIF) Partner Site Bonn\u2010Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Kuster","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University Hospital and University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilona","family":"Kronig","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Transplant Infectious Diseases Unit University Hospitals of Geneva  Geneva 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