Modeling Invasive Aspergillosis Risk for the Application of Prophylaxis Strategies

Jo-Anne H Young; David R Andes; Monica I Ardura; Antonio Arrieta; Eric J Bow; Pranatharthi H Chandrasekar; Sharon C A Chen; Sarah P Hammond; Shahid Husain; Sophia Koo; Valéry Lavergne; M Hong Nguyen; Thomas F Patterson; Miranda So; George R Thompson; C Orla Morrissey; Mindy G Schuster

doi:10.1093/ofid/ofae082

Modeling Invasive Aspergillosis Risk for the Application of Prophylaxis Strategies

Open Forum Infect Dis. 2024 Feb 6;11(3):ofae082. doi: 10.1093/ofid/ofae082. eCollection 2024 Mar.

Authors

Jo-Anne H Young¹, David R Andes², Monica I Ardura³, Antonio Arrieta⁴, Eric J Bow⁵, Pranatharthi H Chandrasekar⁶, Sharon C A Chen⁷, Sarah P Hammond⁸, Shahid Husain⁹, Sophia Koo¹⁰, Valéry Lavergne¹¹, M Hong Nguyen¹², Thomas F Patterson¹³, Miranda So⁹, George R Thompson¹⁴, C Orla Morrissey¹⁵, Mindy G Schuster¹⁶

Affiliations

¹ Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
² Departments of Medicine and Medical Microbiology and Immunology, University of Wisconsin-Madison, Madison, Wisconsin, USA.
³ Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA.
⁴ Department of Pediatrics, Children's Hospital of Orange County, Orange, California, USA.
⁵ Departments of Medical Microbiology and Infectious Diseases, and Internal Medicine, CancerCare Manitoba and the University of Manitoba, Winnipeg, Canada.
⁶ Department of Medicine, Wayne State University, Detroit, Michigan, USA.
⁷ Centre of Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital and the University of Sydney, Sydney, New South Wales, Australia.
⁸ Divisions of Infectious Diseases and Hematology Oncology, Massachusetts General Hospital, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
⁹ University Health Network, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
¹¹ Department of Medical Microbiology and Infection Control, Vancouver General Hospital, Vancouver, British Columbia, University of Montreal Research Center, Montreal, Quebec, Canada.
¹² Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
¹³ Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
¹⁴ Departments of Internal Medicine and Medical Microbiology and Immunology, University of California, Davis, Davis, California, USA.
¹⁵ Department of Infectious Diseases, Monash University, Melbourne, Victoria, Australia.
¹⁶ Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

The epidemiology of invasive aspergillosis (IA) is evolving. To define the patient groups who will most likely benefit from primary or secondary Aspergillus prophylaxis, particularly those whose medical conditions and IA risk change over time, it is helpful to depict patient populations and their risk periods in a temporal visual model. The Sankey approach provides a dynamic figure to understand the risk of IA for various patient populations. While the figure depicted within this article is static, an internet-based version could provide pop-up highlights of any given flow's origin and destination nodes. A future version could highlight links to publications that support the color-coded incidence rates or other actionable items, such as bundles of applicable pharmacologic or non-pharmacologic interventions. The figure, as part of the upcoming Infectious Diseases Society of America's aspergillosis clinical practice guidelines, can guide decision-making in clinical settings.

Keywords: Sankey; antifungal prophylaxis; hematopoietic cell transplantation; invasive aspergillosis; solid organ transplantation.

Publication types

Review