{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:48:57Z","timestamp":1793746137203,"version":"4.6.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Invasive pulmonary aspergillosis (IPA) is a severe infectious disease caused by <jats:italic>Aspergillus<\/jats:italic> spp. It is associated with high mortality, particularly in immunocompromised patients, as well as in those with COVID-19 pneumonia or critically ill individuals in intensive care units (ICUs). Accurate clinical diagnosis remains a significant challenge, often resulting in missed diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study evaluated IPA inpatients diagnosed through mycological evidence and clinical criteria over 12 months. Inclusion criteria required at least one positive mycological result, including a positive culture from bronchoalveolar lavage fluid (BALF) or high-quality sputum, or a positive galactomannan antigen (GM) test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 216 patients were diagnosed with IPA, with a mortality rate of 68.5%. Hematologic malignancies were the primary underlying condition in 33.8% of cases. Voriconazole or posaconazole was used in 45% (98\/216) of patients overall, but only 26% (32\/121) of non-hematologic malignancy patients received these treatments. The 28-day survival rate for patients treated with Voriconazole\/Posaconazole was 0.776 \u00b1 0.038, compared to 0.421 \u00b1 0.043 for untreated patients. Median survival was 130 days (95% CI, 35.3\u2013224.7) for treated patients vs. 20 days (95% CI, 15.8\u201324.2) for untreated patients (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Biomarkers for IPA diagnosis demonstrated high diagnostic value, with area under the curve (AUC) values for GM, G, PCT, IL-6, WBC, NEU%, and D-dimer of 0.953, 0.983, 1.000, 0.999, 0.961, 0.996, and 1.000, respectively. GM levels &amp;gt;0.5 pg\/ml had a positive predictive value of 52.9% (27\/51), while positive mycological culture had a predictive value of 46.5% (33\/71). Multivariable regression analysis identified several significant factors associated with in-hospital mortality: IPA (OR 7.509, 95% CI 4.227\u201313.339, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), Voriconazole\/Posaconazole treatment (OR 0.124, 95% CI 0.063\u20130.242, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), ICU hospitalization (OR 5.280, 95% CI 1.549\u201318.002, <jats:italic>p<\/jats:italic> = 0.008), hematologic malignancy (OR 0.316, 95% CI 0.174\u20130.573, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), and NEU% \u226587.25% (OR 3.409, 95% CI 1.455\u20137.990, <jats:italic>p<\/jats:italic> = 0.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Non-hematologic malignancy patients with IPA were frequently undertreated with antifungal therapy. A comprehensive diagnostic approach using biomarkers, CT, mycological evidence is crucial. Key risk factors for mortality include lack of Voriconazole\/Posaconazole treatment, IPA diagnosis, ICU admission, non-hematologic malignancies, and elevated NEU%.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2025.1587227","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T05:39:32Z","timestamp":1746077972000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation of the clinical characteristics and survival outcomes of invasive pulmonary aspergillosis patients"],"prefix":"10.3389","volume":"16","author":[{"given":"Qiangsheng","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Ha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuejuan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"674","DOI":"10.3390\/jof9060674","article-title":"The use of galactomannan antigen assays for the diagnosis of invasive pulmonary aspergillosis in the hematological patient: a systematic review and meta-analysis","volume":"9","author":"Bukkems","year":"2023","journal-title":"J. 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