⭐ Recent Aspergillosis Research Updates (Week 48)

24 Nov 2025 — Collated new articles (curated highlights)

Top takeaways (clinician focus)

• Burden & mortality: US death‑certificate analysis reinforces substantial aspergillosis‑attributable mortality; IA codes dominate—useful for advocacy and service planning (Walsh et al., CID 2025; PMID 41284728).
• Diagnostics (CPA/ABPA & TB‑survivors): Senegalese post‑TB cohort preprint compares ELISA vs rapid serology for chronic Aspergillus infection—signals for programmatic screening but peer review pending (medRxiv PPR1125158).
• Therapeutics & TDM: Multiple papers underscore voriconazole therapeutic drug monitoring nuances (beyond‑therapeutic levels; contribution of N‑oxide metabolite); anticipate practice pearls for ICU and complex cases.
• Immunology & host‑directed therapy: IL‑37 review summarises antifungal‑modulating effects (↓NLRP3 signalling in murine aspergillosis). Casadevall editorial argues fungal vaccines are feasible (incl. aspirational protection for transplant recipients).
• Comorbidity interfaces: Case data link ABPA with pleuro‑parenchymal Aspergillus infection; ECMO after heart transplant carries notable IA risk; A. niger conidia seen intracellularly in lung‑Tx cytology—diagnostic clue.
• Antifungal susceptibility: Eastern India cohort provides local susceptibility mapping across ABPA/CPA/aspergilloma/IPA phenotypes—supports regional stewardship.
• Policy/consensus: Asia Fungal Working Group Delphi consensus for mold pneumonia in resource‑limited settings—helpful for regional protocols.

Organised evidence table (with copy‑ready links)

1. Aspergillosis‑attributable mortality (USA) — administrative/death‑certificate study
   Clin Infect Dis (2025) — Walsh TJ et al.
   PMID: 41284728
   https://pubmed.ncbi.nlm.nih.gov/41284728/
2. Post‑TB cohort screening for chronic Aspergillus infection (ELISA vs RDT) — preprint
   medRxiv (2025) — Mariama T et al.
   PPR: PPR1125158
   https://www.medrxiv.org/ (search PPR1125158)
3. Voriconazole TDM — beyond‑therapeutic levels in ICU IFI
   BMC Infect Dis (2025) — Lee YC et al.
   PMID: 41275081
   https://pubmed.ncbi.nlm.nih.gov/41275081/
4. Voriconazole N‑oxide metabolite in TDM (case)
   Farm Hosp (2025) — Orozco Cifuentes I et al.
   PMID: 41274859
   https://pubmed.ncbi.nlm.nih.gov/41274859/
5. Antifungal susceptibility of respiratory Aspergillus isolates (Eastern India)
   MicrobiologyOpen (2025) — Nikhil A et al.
   PMID: 41250899; PMCID: PMC12624224
   https://pubmed.ncbi.nlm.nih.gov/41250899/
   https://europepmc.org/article/PMC/12624224
6. IL‑37 in respiratory disease (incl. aspergillosis models) — review
   Front Immunol (2025)
   PMCID: PMC12640846
   https://europepmc.org/article/PMC/12640846
7. Fungal vaccines — feasibility editorial (aspergillosis included)
   J Clin Invest (2025) — Casadevall A
   PMID: 41243962; PMCID: PMC12618062
   https://pubmed.ncbi.nlm.nih.gov/41243962/
   https://europepmc.org/article/PMC/12618062
8. Expert consensus: off‑label/novel antimicrobials (aspergillosis contexts cited)
   JAC Antimicrob Resist (2025)
   PMCID: PMC12641089
   https://europepmc.org/article/PMC/12641089
9. ABPA with pleuro‑parenchymal aspergillus infection — case
   J Postgrad Med (2025) — Spalgais S et al.
   PMID: 41277380
   https://pubmed.ncbi.nlm.nih.gov/41277380/
10. Aspergillus endophthalmitis post‑phaco — failed salvage — case
    Int Ophthalmol (2025) — Huang Z
    PMID: 41247646
    https://pubmed.ncbi.nlm.nih.gov/41247646/
11. Heart Tx on ECMO — infections incl. IA — cohort
    Transplant Direct (2025) — Swiss Transplant Cohort
    PMID: 41268061; PMCID: PMC12629377
    https://pubmed.ncbi.nlm.nih.gov/41268061/
    https://europepmc.org/article/PMC/12629377
12. Mold pneumonia in resource‑limited Asia — Delphi consensus
    Med Mycol (2025) — Asia Fungal Working Group
    PMID: 41251327
    https://pubmed.ncbi.nlm.nih.gov/41251327/
13. A. niger conidia intracellular in AMs — lung Tx cytology clue — case
    Acta Microbiol Immunol Hung (2025)
    PMID: 41269231
    https://pubmed.ncbi.nlm.nih.gov/41269231/
14. Out‑of‑pocket expenditure & QoL in CPA vs PTLD — comparative study
    J Infect Chemother (2025) — Titiyal R et al.
    PMID: 41274342
    https://pubmed.ncbi.nlm.nih.gov/41274342/
15. Destroyed lung pneumonectomy — complications; CPA/haemoptysis associations
    J Surg Res (2025) — Yu L et al.
    PMID: 41270587
    https://pubmed.ncbi.nlm.nih.gov/41270587/
16. Severe asthma immunity — activation signature independent of fungal sensitisation
    Mucosal Immunol (2025) — Plumpton EL et al.
    PMID: 41270906
    https://pubmed.ncbi.nlm.nih.gov/41270906/
17. COVID‑19 & aspergillosis context — perspective linking co‑infection to chronicity risks
    Elife (2025) — Henrich TJ et al.
    PMID: 41247781; PMCID: PMC12622966
    https://pubmed.ncbi.nlm.nih.gov/41247781/
    https://europepmc.org/article/PMC/12622966
18. NTM lung disease outcomes (Italian tertiary centre) — comorbidity context
    Sci Rep (2025) — Carli SM et al.
    PMID: 41249256; PMCID: PMC12623857
    https://pubmed.ncbi.nlm.nih.gov/41249256/
    https://europepmc.org/article/PMC/12623857
19. Mixed mucor + IA coinfection in aplastic anaemia — fatal case
    J Med Case Rep (2025) — Javaherchian P et al.
    PMID: 41272805; PMCID: PMC12639702
    https://pubmed.ncbi.nlm.nih.gov/41272805/
    https://europepmc.org/article/PMC/12639702
20. Sporotrichosis host genes; IA incidence observation — methods paper
    Sci Rep (2025) — Tang Z et al.
    PMID: 41272147; PMCID: PMC12638995
    https://pubmed.ncbi.nlm.nih.gov/41272147/
    https://europepmc.org/article/PMC/12638995
21. SFTS complicated by IPA — prediction nomogram
    BMC Infect Dis (2025) — Yan R et al.
    PMID: 41275152
    https://pubmed.ncbi.nlm.nih.gov/41275152/
22. Data resources landscape incl. Aspergillosis datasets — review
    J Med Syst (2025) — Pokutnaya D et al.
    PMID: 41273456; PMCID: PMC12640313
    https://pubmed.ncbi.nlm.nih.gov/41273456/
    https://europepmc.org/article/PMC/12640313
23. Cell metabolism study using CAPA cohort as comparator
    Cell Mol Life Sci (2025) — Vasilogiannakopoulou T et al.
    PMID: 41258438; PMCID: PMC12630439
    https://pubmed.ncbi.nlm.nih.gov/41258438/
    https://europepmc.org/article/PMC/12630439
24. Preprint: antibiotics → impaired neutrophil anti‑Aspergillus immunity (mouse)
    BioRxiv (2025) — Aufiero MA & Hohl TM
    PPR: PPR1122060
    https://www.biorxiv.org/ (search PPR1122060)
25. Preprint: HosA HDAC in A. fumigatus virulence
    BioRxiv (2025) — Liu H et al.
    PPR: PPR1121973
    https://www.biorxiv.org/ (search PPR1121973)
26. Pulmonary mucormycosis with necrotising pneumonia — differential includes aspergillosis
    BMC Pulm Med (2025) — Duong‑Minh N et al.
    PMID: 41254633; PMCID: PMC12625637
    https://pubmed.ncbi.nlm.nih.gov/41254633/
    https://europepmc.org/article/PMC/12625637
27. Clove (S. aromaticum) essential oil in rabbit aspergillosis — preclinical
    Research Square (2025) — Shokrpoor S et al.
    PPR: PPR1121622
    https://www.researchsquare.com/ (search PPR1121622)
28. Cross‑country multimodal evidence: Aspergillus & biliary atresia — hypothesis‑generating
    Gut Pathog (2025) — Huang SW et al.
    PMID: 41250124; PMCID: PMC12621361
    https://pubmed.ncbi.nlm.nih.gov/41250124/
    https://europepmc.org/article/PMC/12621361