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Abstract
Key messages * PIPA, as defined according to the Blot et al. criteria [9], is a strong predictor of short- and long-term lethal outcome in critically ill patients with COPD. * The use of antibiotics and high cumulative doses of corticosteroids significantly increased the risk of PIPA occurrence in critically ill patients with COPD with Aspergillus lower respiratory tract cultures. * Prompting antifungal treatment in critically ill patients with COPD with PIPA may not be the only factor involved in prognosis reversal. * PIPA was not associated with a dominant pattern of bacterial colonization or infection 6 months before or during fungal infection. Abbreviations BAL: bronchoalveolar lavage CI: confidence interval COPD: chronic obstructive pulmonary disease CR: complete remission EORTC/MSG: European Organization for Research and Treatment of Cancer/Mycosis Study Group FEV1 : forced expiratory volume in 1 second GOLD: Logistic Organ Dysfunction System LRT: lower respiratory tract MV: mechanical ventilation OR: odds ratio PIPA: putative invasive pulmonary aspergillosis RRT: renal replacement therapy SAPS II: