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Volume 31, Number 5—May 2025
CME ACTIVITY - Synopsis

Features of Invasive Aspergillosis Caused by Aspergillus flavus, France, 2012–2018

Lise Bertin-Biasutto, Olivier Paccoud, Dea Garcia-Hermoso, Blandine Denis, Karine Boukris-Sitbon, Olivier Lortholary, Stéphane Bretagne, Maud Gits-Muselli, Raoul Herbrecht, Valérie Letscher-Bru, François Danion, Sophie Cassaing, Florent Morio, Céline Nourrisson, Marc Pihet, Milène Sasso, Guillaume Desoubeaux, Marie-Fleur Durieux, Julie Bonhomme, Elisabeth Chachaty, Taieb Chouaki, Nicole Desbois-Nogard, Alexandre Alanio1, Jean-Pierre Gangneux1, and Fanny LanternierComments to Author 
Author affiliation: Hopital Necker-Enfants Malades, Paris, France (L. Bertin-Biasutto, O. Paccoud, O. Lortholary, F. Lanternier); Université de Paris, Paris (L. Bertin-Biasutto, O. Lortholary, F. Lanternier); Institut Pasteur, Paris (D. Garcia-Hermoso, K. Boukris-Sitbon, O. Lortholary, S. Bretagne, A. Alanio, F. Lanternier); Hôpital Saint Louis, Paris (B. Denis, S. Bretagne, M. Gits-Muselli, A. Aliano); Institut de Cancérologie de Strasbourg, Strasbourg, France (R. Herbrecht); Hôpitaux Universitaires de Strasbourg, Strasbourg (V. Letscher-Bru, F. Danion); Toulouse University Hospital, Toulouse, France (S. Cassaing); Nantes University Hospital, Nantes, France (F. Morio); CHU Clermont-Ferrand, Clermont-Ferrand, France (C. Nourrisson); CHU d'Angers, Angers, France (M. Pihet); CHU Nîmes and Université de Montpellier, Nîmes, France (M. Sasso); Hôpital Bretonneau, Tours, France (G. Desoubeaux); Limoges University, Limoges, France (M.-F. Durieux); Unicaen Université Normandie, Caen, France (J. Bonhomme); Gustave Roussy, Villejuif, France (E. Chachaty); CHU Amiens-Picardie, Amiens, France (T. Chouaki); Inserm U1285, University of Lille, Lille, France (T. Chouaki); Centre Hospitalier Universitaire de Martinique, Fort-de-France, France (N. Desbois-Nogard); Université de Rennes, CHU Rennes, Rennes, France (J.-P. Gangneux); Rennes Teaching Hospital, Rennes (J.-P. Gangneux)

Main Article

Table 2

Main underlying risk factors for 54 patients with probable or proven invasive aspergillosis caused by Aspergillus flavus, France, 2012–2018*

Characteristics HM, n = 29 SOC, n = 2 SOT, n = 9 DM, n = 8 Other, n = 2 Severe burns, n = 2 No risk factors, n = 2 p value†
Median age, y (IQR)
 53 (28–66)
 73 (66–80)
 60 (57–70)
 72.5 (70–74)
 49 (48–50)
 60 (50–69)
 21 (16–25)
 <0.001
Originating from Africa, n = 26
 5/26 (19.2)
 0
 2/8 (25)
 5 (62.5)
 0
 0
 2 (100)
 0.02
Sex
M 12 (41.4) 1 (50) 5 (55.6) 5 (62.5) 1 (50) 0 1 (50) 0.46
F
 17 (58.6)
 1 (50)
 4 (44.4)
 3 (37.5)
 1 (50)
 2 (100)
 1 (50)
 0.46
Median delay to diagnosis, d (IQR)
 17 (5–30)
 5 (2–7)
 20 (13.5–54)
 105 (68–163)
 32 (20–43)
 7 (5–9)
 ­NA
 <0.001
Neutropenia‡§
 26 (89.6)
 0
 1/8 (12)
 0
 1 (50)
 0
 0
 <0.001
Positive serum galactomannan antigen§
 15/22 (68.1)
 1/1 (100)
 3/7 (43)
 2/4 (50)
 1 (50)
 1 (50)
 0
 0.63
Infection site
Disseminated infection 4 (13.7) 1 (50) 1 (11.1) 0 0 1 (50) 0 0.57
Localized infection 25 (86.2) 1 (50) 8 (88.9) 8 (100) 2 (100) 1 (50) 2 (100) 0.57
Pleuropulmonary 23/25 (92) 0 7/8 (87.5) 0 2 (100) 0 1 (50) <0.001
ENT 2/25 (8) 1/1 (100) 1/8 (12.5) 8/8 (100) 0 0 1 (50) <0.001
CNS 0 1/1 (100) 1/8 (12.5) 7/8 (87.5) 0 0 1 (50) <0.001
Skin and soft tissue
 0
 0
 0
 0
 0
 1 (100)
 0
 >0.999
First-line antifungal therapy¶ N = 27 N = 7
Voriconazole 18 (66.7) 2 (100) 3 (4.8) 6/8 (75) 1 (50) 1 (50) 1 (50) 0.69
L-AmB 5 (18.5) 0 2 (28.6) 0/8 (0) 1 (50) 1 (50) 0 0.32
Other agent
 6 (22.2)
 0
 2 (28.6)
 3/8 (37.5)
 1 (50)
 0
 1 (50)
 0.41
Death N = 28 N = 1 N = 8
30-d CFR 13 (46.4) 0 4 (44.4) 0 1 (50) 2 (100) 0 0.017
90-d CFR 15 (53.6) 0 5 (55.6) 1 (12.5) 1 (50) 2 (100) 0 0.052

*Values are no. (%) except as indicated. Bold font indicates statistical significance. CFR, case-fatality rate; CNS, central nervous system; DM, diabetes mellitis; ENT, ear-nose-throat; HM, hemolytic malignancy; IQR, interquartile range; L-AmB, liposomal amphotericin B; NA, not applicable; SOC, solid organ cancer; SOT, solid organ transplant. †For solid organ transplant, solid organ cancer, hemolytic malignancy, and other versus diabetes mellitis. ‡<0.5 × 103 cells/mL §No. positive/no. tested (%). ¶Including combination therapy. Other first-line agents included posaconazole, itraconazole, isavuconazole, and echinocandin.

Main Article

1These authors contributed equally contributed to this article.

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