{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:41:16Z","timestamp":1791499276771,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Allogeneic hemopoietic stem cell transplant (aHSCT) recipients are at high\u2010risk for invasive fungal disease (IFD), even with mould\u2010active antifungal prophylaxis (AFP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective, observational, single\u2010center cohort study involving 300 adult aHSCT recipients transplanted from January 2017\u2013May 2020. Patient demographics, underlying hematological malignancy (HM), transplant characteristics and AFP were described. The primary objectives were rate and characteristics of breakthrough IFD (bIFD) within 1\u2010year post\u2010transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 300 aHSCT recipients, 195 (65%) were males; median age at transplantation was 54 years (IQR 43\u201362). Acute leukemia was the most common underlying HM (50%), and modified\u2010release posaconazole was the main primary AFP (88%). B\u2010IFD occurred in 26 patients (9%): 14 breakthrough invasive mould diseases (bIMD), which\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      species predominated (56%), followed by\n                      <jats:italic>Lomentospora prolificans<\/jats:italic>\n                      (31%); and 12 breakthrough invasive yeast infections, with\n                      <jats:italic>Nakaseomyces glabratus<\/jats:italic>\n                      most frequently isolated. Neither\n                      <jats:italic>Aspergillus fumigatus<\/jats:italic>\n                      complex nor\n                      <jats:italic>Candida albicans<\/jats:italic>\n                      was cultured as breakthrough organisms. bIMD occurred late post aHSCT at median of 167 days, whereas breakthrough invasive yeast infection occurred at median of 21 days. Twelve patients (46%) had therapeutic\u2010drug\u2010monitoring at time of bIFD\u2014all were within therapeutic range. All\u2010cause mortality at 12\u2010weeks from bIMD and breakthrough invasive yeast infection infections were 50% and 58%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Although bIFD rate was consistent with other reports, mortality after bIFD remained significant. Use of mould\u2010active AFP likely explained the changing epidemiology of fungal isolates. Resistant breakthrough fungal organisms, especially\n                      <jats:italic>L. prolificans<\/jats:italic>\n                      , reflected local epidemiology. Ongoing surveillance of IFD including resistant organisms is warranted to optimize treatment and patient outcome.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70104","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T15:49:26Z","timestamp":1758901766000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Changing Epidemiology of Breakthrough Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplant Recipients in the Era of Modified\u2010Release Posaconazole Prophylaxis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2774-2237","authenticated-orcid":false,"given":"Shio Yen","family":"Tio","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"National Centre For Infections in Cancer  Melbourne Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Australia"},{"name":"Victorian Infectious Diseases Service (VIDS) Royal Melbourne Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin Fen","family":"Neoh","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"National Centre For Infections in Cancer  Melbourne Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Department of Clinical Haematology Peter Maccallum Cancer Centre The Royal Melbourne Hospital  Melbourne Australia"},{"name":"Department of Medicine University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynette","family":"Chee","sequence":"additional","affiliation":[{"name":"Department of Clinical Haematology Peter Maccallum Cancer Centre The Royal Melbourne Hospital  Melbourne Australia"},{"name":"Department of Medicine University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C. M.","family":"Kong","sequence":"additional","affiliation":[{"name":"National Centre For Infections in Cancer  Melbourne Australia"},{"name":"The National Centre for Antimicrobial Stewardship The Peter Doherty Institute for Infections and Immunity  Melbourne Australia"},{"name":"Faculty of Pharmacy and Pharmaceutical Sciences, Centre For Medicine Use and Safety Monash Institute of Pharmaceutical Sciences Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon J.","family":"Worth","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"National Centre For Infections in Cancer  Melbourne Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle K.","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"National Centre For Infections in Cancer  Melbourne Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Australia"},{"name":"Victorian Infectious Diseases Service (VIDS) Royal Melbourne Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica A.","family":"Slavin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"National Centre For Infections in Cancer  Melbourne Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Australia"},{"name":"Victorian Infectious Diseases Service (VIDS) Royal Melbourne Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13148"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2023.05.005"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae203"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof6040216"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.04.017"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks189"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12688"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix130"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01791-16"},{"key":"e_1_2_10_11_1","volume-title":"Non\u2010Aspergillus Mould (NAM) Infections in Australia and New Zealand: A Multi\u2010Centre Study on Epidemiology and Clinical Outcomes","author":"Neoh C. 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