ESCMID-ECMM guideline: diagnosis and management of invasive aspergillosis in neonates and children

Adilia Warris; Thomas Lehrnbecher; Emmanuel Roilides; Elio Castagnola; Roger J. M. Bruggemann; Andreas H. Groll

doi:10.1016/j.cmi.2019.05.019

ESCMID-ECMM guideline: diagnosis and management of invasive aspergillosis in neonates and children

Adilia Warris^* (Corresponding Author), Thomas Lehrnbecher, Emmanuel Roilides, Elio Castagnola, Roger J. M. Bruggemann, Andreas H. Groll

^*Corresponding author for this work

Applied Medicine

Research output: Contribution to journal › Article › peer-review

119 Citations (Scopus)

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Abstract

Scope: Presenting symptoms, distributions and patterns of diseases and vulnerability to invasive aspergillosis (IA) are similar between children and adults. However, differences exist in the epidemiology and underlying conditions, the usefulness of newer diagnostic tools, the pharmacology of antifungal agents and in the evidence from interventional phase III clinical trials. Therefore, the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM) have developed a paediatric specific guideline for the diagnosis and management of IA in neonates and children.

Methods: Review and discussion of the scientific literature and grading of the available quality of evidence was performed by the paediatric subgroup of the ESCMID-ECMMEuropean Respiratory Society (ERS) Aspergillus disease guideline working group, which was assigned the mandate for the development of neonatal and paediatric specific recommendations.

Questions: Questions addressed by the guideline included the epidemiology of IA in neonates and children; which paediatric patients may benefit from antifungal prophylaxis; how to diagnose IA in neonates and children; which antifungal agents are available for use in neonates and children; which antifungal agents are suitable for prophylaxis and treatment of IA in neonates and children; what is the role of therapeutic drug monitoring of azole antifungals and which management strategies are suitable to be used in paediatric patients. This guideline provides recommendations for the diagnosis, prevention and treatment of IA in the paediatric population, including neonates. The aim of this guideline is to facilitate optimal management of neonates and children at risk for or diagnosed with IA.

Original language	English
Pages (from-to)	1096-1113
Number of pages	18
Journal	Clinical Microbiology and Infection
Volume	25
Issue number	9
Early online date	31 May 2019
DOIs	https://doi.org/10.1016/j.cmi.2019.05.019
Publication status	Published - Sept 2019

Bibliographical note

ACKNOWLEDGEMENT
Prof Warris is supported by the Wellcome Trust Strategic Award (grant 097377) and the MRC Centre for Medical Mycology (grant MR/N006364/1) at the University of Aberdeen.

FUNDING
European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the
European Confederation of Medical Mycology (ECMM)

Keywords

antifungal prophylaxis
antifungal therapy
aspergillosis
neonates,children
Antifungal therapy
Neonates
Aspergillosis
Antifungal prophylaxis
Children
BRONCHOALVEOLAR LAVAGE GALACTOMANNAN
POPULATION PHARMACOKINETIC ANALYSIS
CHRONIC GRANULOMATOUS-DISEASE
EMPIRICAL ANTIFUNGAL THERAPY
BETA-D-GLUCAN
LIPOSOMAL AMPHOTERICIN-B
PEDIATRIC CANCER-PATIENTS
POLYMERASE-CHAIN-REACTION
ITRACONAZOLE ORAL SOLUTION
STEM-CELL TRANSPLANTATION

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Accepted Manuscript
© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0
Accepted author manuscript, 320 KBLicence: CC BY-NC-ND
Accepted Manuscript TablesAccepted author manuscript, 274 KBLicence: CC BY-NC-ND

Cite this

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title = "ESCMID-ECMM guideline: diagnosis and management of invasive aspergillosis in neonates and children",

abstract = "Scope: Presenting symptoms, distributions and patterns of diseases and vulnerability to invasive aspergillosis (IA) are similar between children and adults. However, differences exist in the epidemiology and underlying conditions, the usefulness of newer diagnostic tools, the pharmacology of antifungal agents and in the evidence from interventional phase III clinical trials. Therefore, the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM) have developed a paediatric specific guideline for the diagnosis and management of IA in neonates and children.Methods: Review and discussion of the scientific literature and grading of the available quality of evidence was performed by the paediatric subgroup of the ESCMID-ECMMEuropean Respiratory Society (ERS) Aspergillus disease guideline working group, which was assigned the mandate for the development of neonatal and paediatric specific recommendations.Questions: Questions addressed by the guideline included the epidemiology of IA in neonates and children; which paediatric patients may benefit from antifungal prophylaxis; how to diagnose IA in neonates and children; which antifungal agents are available for use in neonates and children; which antifungal agents are suitable for prophylaxis and treatment of IA in neonates and children; what is the role of therapeutic drug monitoring of azole antifungals and which management strategies are suitable to be used in paediatric patients. This guideline provides recommendations for the diagnosis, prevention and treatment of IA in the paediatric population, including neonates. The aim of this guideline is to facilitate optimal management of neonates and children at risk for or diagnosed with IA.",

keywords = "antifungal prophylaxis, antifungal therapy, aspergillosis, neonates,children, Antifungal therapy, Neonates, Aspergillosis, Antifungal prophylaxis, Children, BRONCHOALVEOLAR LAVAGE GALACTOMANNAN, POPULATION PHARMACOKINETIC ANALYSIS, CHRONIC GRANULOMATOUS-DISEASE, EMPIRICAL ANTIFUNGAL THERAPY, BETA-D-GLUCAN, LIPOSOMAL AMPHOTERICIN-B, PEDIATRIC CANCER-PATIENTS, POLYMERASE-CHAIN-REACTION, ITRACONAZOLE ORAL SOLUTION, STEM-CELL TRANSPLANTATION",

author = "Adilia Warris and Thomas Lehrnbecher and Emmanuel Roilides and Elio Castagnola and Bruggemann, {Roger J. M.} and Groll, {Andreas H.}",

note = "ACKNOWLEDGEMENT Prof Warris is supported by the Wellcome Trust Strategic Award (grant 097377) and the MRC Centre for Medical Mycology (grant MR/N006364/1) at the University of Aberdeen. FUNDING European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM)",

year = "2019",

month = sep,

doi = "10.1016/j.cmi.2019.05.019",

language = "English",

volume = "25",

pages = "1096--1113",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier",

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}

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T1 - ESCMID-ECMM guideline

T2 - diagnosis and management of invasive aspergillosis in neonates and children

AU - Warris, Adilia

AU - Lehrnbecher, Thomas

AU - Roilides, Emmanuel

AU - Castagnola, Elio

AU - Bruggemann, Roger J. M.

AU - Groll, Andreas H.

N1 - ACKNOWLEDGEMENT Prof Warris is supported by the Wellcome Trust Strategic Award (grant 097377) and the MRC Centre for Medical Mycology (grant MR/N006364/1) at the University of Aberdeen. FUNDING European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM)

PY - 2019/9

Y1 - 2019/9

N2 - Scope: Presenting symptoms, distributions and patterns of diseases and vulnerability to invasive aspergillosis (IA) are similar between children and adults. However, differences exist in the epidemiology and underlying conditions, the usefulness of newer diagnostic tools, the pharmacology of antifungal agents and in the evidence from interventional phase III clinical trials. Therefore, the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM) have developed a paediatric specific guideline for the diagnosis and management of IA in neonates and children.Methods: Review and discussion of the scientific literature and grading of the available quality of evidence was performed by the paediatric subgroup of the ESCMID-ECMMEuropean Respiratory Society (ERS) Aspergillus disease guideline working group, which was assigned the mandate for the development of neonatal and paediatric specific recommendations.Questions: Questions addressed by the guideline included the epidemiology of IA in neonates and children; which paediatric patients may benefit from antifungal prophylaxis; how to diagnose IA in neonates and children; which antifungal agents are available for use in neonates and children; which antifungal agents are suitable for prophylaxis and treatment of IA in neonates and children; what is the role of therapeutic drug monitoring of azole antifungals and which management strategies are suitable to be used in paediatric patients. This guideline provides recommendations for the diagnosis, prevention and treatment of IA in the paediatric population, including neonates. The aim of this guideline is to facilitate optimal management of neonates and children at risk for or diagnosed with IA.

AB - Scope: Presenting symptoms, distributions and patterns of diseases and vulnerability to invasive aspergillosis (IA) are similar between children and adults. However, differences exist in the epidemiology and underlying conditions, the usefulness of newer diagnostic tools, the pharmacology of antifungal agents and in the evidence from interventional phase III clinical trials. Therefore, the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM) have developed a paediatric specific guideline for the diagnosis and management of IA in neonates and children.Methods: Review and discussion of the scientific literature and grading of the available quality of evidence was performed by the paediatric subgroup of the ESCMID-ECMMEuropean Respiratory Society (ERS) Aspergillus disease guideline working group, which was assigned the mandate for the development of neonatal and paediatric specific recommendations.Questions: Questions addressed by the guideline included the epidemiology of IA in neonates and children; which paediatric patients may benefit from antifungal prophylaxis; how to diagnose IA in neonates and children; which antifungal agents are available for use in neonates and children; which antifungal agents are suitable for prophylaxis and treatment of IA in neonates and children; what is the role of therapeutic drug monitoring of azole antifungals and which management strategies are suitable to be used in paediatric patients. This guideline provides recommendations for the diagnosis, prevention and treatment of IA in the paediatric population, including neonates. The aim of this guideline is to facilitate optimal management of neonates and children at risk for or diagnosed with IA.

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KW - PEDIATRIC CANCER-PATIENTS

KW - POLYMERASE-CHAIN-REACTION

KW - ITRACONAZOLE ORAL SOLUTION

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JF - Clinical Microbiology and Infection

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ER -

ESCMID-ECMM guideline: diagnosis and management of invasive aspergillosis in neonates and children

Abstract

Bibliographical note

Keywords

UN SDGs

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