Incidence and outcome of invasive fungal diseases after allogeneic hematopoietic stem cell transplantation: A Swiss transplant cohort study

被引：41

作者：

Kuster, Sabine ^{[1
,2
]}

Stampf, Susanne ^{[3
]}

Gerber, Bernhard ^{[4
]}

Baettig, Veronika ^{[1
,2
]}

Weisser, Maja ^{[1
,2
]}

Gerull, Sabine ^{[5
]}

Medinger, Michael ^{[5
]}

Passweg, Jakob ^{[5
]}

Schanz, Urs ^{[6
,7
]}

Garzoni, Christian ^{[8
,9
]}

Berger, Christoph ^{[10
]}

Chalandon, Yves ^{[11
]}

Mueller, Nicolas J. ^{[12
]}

van Delden, Christian ^{[13
]}

Neofytos, Dionysios ^{[13
]}

Khanna, Nina ^{[1
,2
]}

机构：

[1] Univ Basel, Div Infect Dis & Hosp Epidemiol, Basel, Switzerland

[2] Univ Hosp Basel, Basel, Switzerland

[3] Univ Hosp Basel, Clin Transplantat Immunol & Nephrol, Basel, Switzerland

[4] Oncol Inst Southern Switzerland, Div Hematol, Bellinzona, Switzerland

[5] Univ Hosp Basel, Div Hematol, Basel, Switzerland

[6] Univ Zurich, Div Hematol, Zurich, Switzerland

[7] Univ Hosp Zurich, Zurich, Switzerland

[8] Clin Luganese, Clin Internal Med & Infect Dis, Lugano, Switzerland

[9] Univ Bern, Univ Hosp Bern, Inselspital, Dept Infect Dis, Bern, Switzerland

[10] Univ Childrens Hosp Zurich, Div Infect Dis & Hosp Epidemiol, Zurich, Switzerland

[11] Univ Hosp Geneva, Div Hematol, Geneva, Switzerland

[12] Univ Hosp Zurich, Div Infect Dis & Hosp Epidemiol, Zurich, Switzerland

[13] Univ Hosp Geneva, Transplant Infect Dis Unit, Geneva, Switzerland

来源：

TRANSPLANT INFECTIOUS DISEASE | 2018年 / 20卷 / 06期

基金：

瑞士国家科学基金会;

关键词：

breakthrough infections; hematopoietic stem cell transplantation; invasive fungal diseases; invasive mold disease; MYCOSES STUDY-GROUP; MARROW TRANSPLANTATION; IMMUNE RECONSTITUTION; EUROPEAN-ORGANIZATION; ANTIFUNGAL THERAPY; MOLD INFECTIONS; RISK-FACTORS; 2016; UPDATE; FLUCONAZOLE; PROPHYLAXIS;

D O I：

10.1111/tid.12981

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Contemporary, comprehensive data on epidemiology and outcomes of invasive fungal disease (IFD) including breakthrough IFD among allogeneic hematopoietic stem cell transplantation (HSCT) recipients are scarce. We included 479 allogeneic HSCT recipients with 10 invasive candidiasis (IC) and 31 probable/proven invasive mold disease (IMD) from the Swiss Transplant Cohort Study from 01.2009 to 08.2013. Overall cumulative incidence was 2.3% for IC and 8.5% for probable/proven IMI: 6% for invasive aspergillosis (IA) and 2.5% for non-Aspergillus IMI. Among 41 IFD, 46% IFD were breakthrough, with an overall incidence of 4.6%, more frequently caused by other-than-Aspergillus fumigatus molds than primary IFD (47.6% (10/21) vs 13% (3/23), P = 0.04). Twelve-week mortality among patients with IC was 20% and 58.6% for probable/proven IMD (60% IA and 54.6% non-Aspergillus). Our results reveal that breakthrough IFD represent a marked burden of probable/proven IFD postallogeneic HSCT and mortality remains above 50% in patients with probable/proven IMD, underscoring the ongoing challenges to prevent and treat IFD in these patients.

引用

页数：8

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