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|Title:||Consensus guidelines for the diagnosis and management of invasive aspergillosis, 2021.||Austin Authors:||Douglas, Abby P;Smibert, Olivia C ;Bajel, Ashish;Halliday, Catriona L;Lavee, Orly;McMullan, Brendan;Yong, Michelle K;van Hal, Sebastiaan J;Chen, Sharon C-A||Affiliation:||Infectious Diseases..
Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia..
School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia..
Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Sydney, New South Wales, Australia..
Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia..
Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia..
Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia..
Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia..
Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia..
Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia..
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia..
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia..
Department of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia..
|Issue Date:||Nov-2021||Publication information:||Internal medicine journal 2021; 51 Suppl 7: 143-176||Abstract:||Invasive aspergillosis (IA) in haematology/oncology patients presents as primary infection or breakthrough infection, which can become refractory to antifungal treatment and has a high associated mortality. Other emerging patient risk groups include patients in the intensive care setting with severe respiratory viral infections, including COVID-19. These guidelines present key diagnostic and treatment recommendations in light of advances in knowledge since the previous guidelines in 2014. Culture and histological-based methods remain central to the diagnosis of IA. There is increasing evidence for the utility of non-culture methods employing fungal biomarkers in pre-emptive screening for infection, as well as for IA diagnosis when used in combination. Although azole resistance appears to be uncommon in Australia, susceptibility testing of clinical Aspergillus fumigatus complex isolates is recommended. Voriconazole remains the preferred first-line antifungal agent for treating primary IA, including for extrapulmonary disease. Recommendations for paediatric treatment broadly follow those for adults. For breakthrough and refractory IA, a change in class of antifungal agent is strongly recommended, and agents under clinical trial may need to be considered. Newer immunological-based imaging modalities warrant further study, while surveillance for IA and antifungal resistance remain essential to informing the relevance of current treatment recommendations.||URI:||https://ahro.austin.org.au/austinjspui/handle/1/28560||DOI:||10.1111/imj.15591||ORCID:||0000-0003-1232-5884||Journal:||Internal medicine journal||PubMed URL:||34937136||PubMed URL:||https://pubmed.ncbi.nlm.nih.gov/34937136/||Type:||Journal Article||Subjects:||Aspergillus
stem cell transplant
|Appears in Collections:||Journal articles|
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