Synergistic impact of Gram-negative bacterial co-infection on invasive pulmonary aspergillosis in non-neutropenic patients: a machine learning-based risk stratification approach

Gram-negative bacterial co-infection synergistically amplifies IPA risk in non-neutropenic patients. The ensemble ML model integrating seven pragmatic predictors provides accurate, interpretable, and clinically actionable stratification, enabling precision prophylaxis and early antifungal intervention. Prospective multicenter validation is warranted before clinical implementation.