Frédéric Lamoth, Werner C. Albrich, Silvio Ragozzino, Davide Bosetti, J. Delaloye, C. El Khoury, Aline Munting, Vera Portillo, Ilana Reinhold, Johannes Sumer, Andrea Zbinden, V. Bättig, Catherine Beigelman‐Aubry, K. Boggian, Anna Conen, Tim Fischer, Christian Garzoni, Daniel Goldenberger, Eveline Hofmann, Philippe Khafagy, Linda Kern, Gian‐Reto Kleger, Christophe Le Terrier, Oscar Marchetti, Jean‐Luc Pagani, Niels J. Rupp, Peter W. Schreiber, Martin Siegemund, F. Kadgien, Dionysios Neofytos, Nina Khanna, the Fungal Infection Network of Switzerland (FUNGINOS)
Invasive pulmonary aspergillosis (IPA) is increasingly recognised in intensive care units (ICU) affecting not only patients with classical immunosuppressive conditions but also other severely ill patients, including those with respiratory viral infections (influenza, COVID-19), advanced chronic obstructive pulmonary disease or acute and chronic liver diseases. Several expert panels have proposed definitions of IPA in different ICU settings. However, practical recommendations for its diagnostic and therapeutic approaches are scarce. Moreover, these approaches can be influenced by different parameters that may vary across countries including the case mix of ICU patients, the incidence of IPA, the prevalence of azole resistance and the availability of diagnostic tests and antifungal drugs. For these reasons, the Fungal Infection Network of Switzerland (FUNGINOS) has appointed a panel of different specialists to develop a practical guideline for the management of IPA in ICU. This article provides the executive summary of the panel conclusions and recommendations regarding the epidemiology, diagnosis, definitions and therapy of IPA in ICU.