Invasive aspergillosis epidemiology

Invasive molds, particularly Aspergillus, have become an increasingly important complication of cancer therapy and organ transplantation. Patients with acute leukemia and recipients of allogeneic hematopoietic cell transplants are at especially high risk for invasive aspergillosis (IA) due to prolonged neutropenia and deficiencies in cellmediated immunity associated with graft-versus-host disease and its treatment. More than 180 species within the genus Aspergillus have been described, but only four species are commonly associated with invasive infection: Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, and Aspergillus niger. Of these four species, A. fumi gatus accounts for most of human infections. However, identification of Aspergillus mold in culture to the species level is still essential because the incidence of ampho-tericin B-resistant Aspergillus terreus and Aspergillus flavus have increased over the last 10 years among high-risk patients. Early and accurate diagnosis of IA remains the most important barrier to the effective management of this infection, which is associ-

ated with crude mortality rates ranging from 60% to 100%.

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