Contributions
Type: Publication Only
Background
The invasive fungal infections (IFIs) are associated with a very high mortality in hematologic patients mainly because of asymptomatic course and delayed diagnosis.
Aims
The aim of the study was to analyze the clinical feature and outcome of invasive fungal infections in adult patients diagnosed and treated in Wroclaw Medical University.
Methods
The retrospective analysis of patients with hematologic malignancies and patients undergone hematopoietic stem cell transplant (HSCT), who were hospitalized in our hospital between January 2011 and December 2014, was performed. Proven, probable and possible IFIs were diagnosed according to the definitions of EORTC/IFICG. Galactomannan and mannan antigens were detected by ELISA whereas culture of pathogenic fungi was based on EUCAST recommendations.
Results
In analyzed period, invasive fungal infection was diagnosed in 55 patients, of which 34 (62%) was proven, 19(34,5%) probable, and 2(3,5%) possible. Aspergillosis was diagnosed in 50/55 patients, candidosis in 3/55 patients, mucormysosis in 1/55, and cryptococcosis in one patient (1/55). The major pathogens isolated form clinical specimens were: Aspergillus fumigatus (21/55,38.2%), Aspergillus flavus (2/55, 3.6%), Aspergillus niger (1/55, 1.8%), Absidia (1/55, 1.8%), Mucor (1/55, 1.8%), Candida glabrata (3/55, 5.5%). In two patients two different Aspergillus spp. (A. fumigatus and A. flavus) were identified from lower respiratory tract. The infection was mostly localized in lungs (48/55,87.2%), and central nervous system (4/55, 7.3%). Disseminated infection was noted in two patients (3/55, 5.5%). IFIs were most common in patients with acute myeloid leukemia (27/55, 49%) and patients undergone HSCT (8/55, 14.5%). The major risk factors in this patients were prolonged neutropenia and degree of immunosupression. A total of 39 patients (71%) died.
Summary
The most common pathogen of invasive fungal infection in the cohort of hematologic patients was Aspergillus fumigatus. Constant monitoring of the epidemiologic trends and insights in timing of fungal infections in this patients may help to improve the effective prevention and treatment strategies.
Keyword(s): Aspergillus, Fungal infection, Hematopoietic cell transplantation
Session topic: Publication Only
Type: Publication Only
Background
The invasive fungal infections (IFIs) are associated with a very high mortality in hematologic patients mainly because of asymptomatic course and delayed diagnosis.
Aims
The aim of the study was to analyze the clinical feature and outcome of invasive fungal infections in adult patients diagnosed and treated in Wroclaw Medical University.
Methods
The retrospective analysis of patients with hematologic malignancies and patients undergone hematopoietic stem cell transplant (HSCT), who were hospitalized in our hospital between January 2011 and December 2014, was performed. Proven, probable and possible IFIs were diagnosed according to the definitions of EORTC/IFICG. Galactomannan and mannan antigens were detected by ELISA whereas culture of pathogenic fungi was based on EUCAST recommendations.
Results
In analyzed period, invasive fungal infection was diagnosed in 55 patients, of which 34 (62%) was proven, 19(34,5%) probable, and 2(3,5%) possible. Aspergillosis was diagnosed in 50/55 patients, candidosis in 3/55 patients, mucormysosis in 1/55, and cryptococcosis in one patient (1/55). The major pathogens isolated form clinical specimens were: Aspergillus fumigatus (21/55,38.2%), Aspergillus flavus (2/55, 3.6%), Aspergillus niger (1/55, 1.8%), Absidia (1/55, 1.8%), Mucor (1/55, 1.8%), Candida glabrata (3/55, 5.5%). In two patients two different Aspergillus spp. (A. fumigatus and A. flavus) were identified from lower respiratory tract. The infection was mostly localized in lungs (48/55,87.2%), and central nervous system (4/55, 7.3%). Disseminated infection was noted in two patients (3/55, 5.5%). IFIs were most common in patients with acute myeloid leukemia (27/55, 49%) and patients undergone HSCT (8/55, 14.5%). The major risk factors in this patients were prolonged neutropenia and degree of immunosupression. A total of 39 patients (71%) died.
Summary
The most common pathogen of invasive fungal infection in the cohort of hematologic patients was Aspergillus fumigatus. Constant monitoring of the epidemiologic trends and insights in timing of fungal infections in this patients may help to improve the effective prevention and treatment strategies.
Keyword(s): Aspergillus, Fungal infection, Hematopoietic cell transplantation
Session topic: Publication Only