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Grant support

Our group is recognised by the AGAUR (Project 2017SGR1432) the Catalan Health Agency. CG-V [FIS PI18/01061], PP-A[CM18/00132], EM-G [PI18/01061] and NG-P [FI19/00133] have received research grants from the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III, and the European RegionalDevelopment Fund. No funding body had any role in the studydesign, data collection and analysis, decision to publish, or preparation of the manuscript.

Analysis of institutional authors

Fernández-Pittol MCorresponding AuthorRubio-García EAuthorPitart CAuthor

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June 28, 2022
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Aspergillosis by cryptic Aspergillus species: A case series and review of the literature

Publicated to:Revista Iberoamericana De Micologia. 39 (2): 44-49 - 2022-06-01 39(2), DOI: 10.1016/j.riam.2022.04.002

Authors: Fernandez-Pittol, M; Alejo-Cancho, I; Rubio-García, E; Cardozo, C; Puerta-Alcalde, P; Moreno-García, E; Garcia-Pouton, N; Garrido, M; Villanueva, M; Alastruey-Izquierdo, A; Pitart, C; Garcia-Vidal, C; Marco, F

Affiliations

Department of Microbiology, Hospital Clinic, Barcelona, Spain - Author
Hosp Clin Barcelona, Dept Microbiol, Barcelona, Spain - Author
Hosp Clin Barcelona, Infect Dis Dept, IDIBAPS, Barcelona, Spain - Author
Inst Salud Carlos III, Natl Ctr Microbiol, Mycol Reference Lab, Majadahonda, Spain - Author
Univ Barcelona, Barcelona, Spain - Author
Univ Barcelona, Inst Global Hlth, ISGlobal Barcelona, Barcelona, Spain - Author
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Abstract

Background: The cryptic Aspegillus species are rare, these microorganisms are usually more resistant to common antifungal therapies. Therefore, a correct identification is important when evaluating the impact of such species in aspergillosis. Aims: We aimed to describe the frequency, clinical and microbiological characteristics, and the outcomes of those cases of aspergillosis caused by cryptic species in a tertiary hospital. Methods: We retrospectively identified all microbiologically documented cases of aspergillosis between January 2013 and December 2018. Definitive species identification of clinically significant isolates was achieved via sequencing methods. The polymerase chain reaction (PCR) products were sequenced, and the results obtained were compared to sequences deposited in GenBank. Antifungal susceptibility testing was performed using the Sensititre® YeastOne® panel. Results: A total of 679 Aspergillus isolates were recovered from 489 patients, of which 109 were clinically relevant. Ten (9.2%) isolates were identified as cryptic species: Aspergillus arcoverdensis (2), Aspergillus lentulus (2), Aspergillus ellipticus (2), Aspergillus alliaceus (1), Aspergillus nomius (1), Aspergillus tubingensis (1) and Aspergillus montevidensis (1). Most patients already suffered some type of immunosuppression. Half of these patients had required intensive care before the infection showed up, and most of them had a pulmonary infection. Mortality at the 100-day follow-up was 40%. Antifungal susceptibility testing was performed on three of the isolates (A. arcoverdensis, A. tubingensis and A. nomius), which showed high minimum inhibitory concentrations (MIC) for azoles and amphotericin B. Conclusions: The frequency of cryptic species in our centre was 9.2%. Most patients had some degree of immunosuppression, and the mortality rate was 40%. © 2022 Asociación Española de Micología

Keywords

aspergillusbreakthrough fungal infectionresistanceresistant fungisection fumigatisusceptibilityAmphotericin bAntifungal agentAntifungal agentsAspergillosisAspergillusBreakthrough fungal infectionCryptic speciesEspecies crípticasHongos multirresistentesHumanHumansInfección fúngica de brechaInvasive pulmonary aspergillosisMicrobial sensitivity testMicrobial sensitivity testsMicrobiologyResistant fungiRetrospective studiesRetrospective study

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Revista Iberoamericana De Micologia, and although the journal is classified in the quartile Q4 (Agencia WoS (JCR)), its regional focus and specialization in Mycology, give it significant recognition in a specific niche of scientific knowledge at an international level.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.85. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 1.21 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 6.19 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-07, the following number of citations:

  • WoS: 15
  • Scopus: 14
  • Europe PMC: 6

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-07:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 17.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 23 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 0.25.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Fernandez Pittol, Mariana) and Last Author (Marco F).

the author responsible for correspondence tasks has been Fernandez Pittol, Mariana.