Fungaemia in haematological malignancies: SEIFEM-2015 survey

被引：30

作者：

Criscuolo, Marianna ^{[1
]}

Marchesi, Francesco ^{[2
]}

Candoni, Anna ^{[3
]}

Cattaneo, Chiara ^{[4
]}

Nosari, Annamaria ^{[5
]}

Veggia, Barbara ^{[6
]}

Verga, Luisa ^{[7
]}

Fracchiolla, Nicola ^{[8
]}

Vianelli, Nicola ^{[9
]}

Del Principe, Maria Ilaria ^{[10
]}

Picardi, Marco ^{[11
]}

Tumbarello, Mario ^{[12
]}

Aversa, Franco ^{[13
]}

Busca, Alessandro ^{[14
]}

Pagano, Livio ^{[15
]}

Dragonetti, Giulia ^{[15
]}

Ballanti, Stelvio ^{[16
]}

Delia, Mario ^{[17
]}

Nadali, Gianpaolo ^{[18
]}

Sciume, M. ^{[8
]}

Castagnola, C. ^{[19
]}

Ferrari, A.

Mancini, V ^{[5
]}

Decembrino, N. ^{[20
]}

Spolzino, A. ^{[21
,22
]}

Iovino, L. ^{[23
]}

Martino, B. ^{[24
]}

Vacca, A. ^{[25
]}

Calore, E. ^{[26
]}

Fanci, R. ^{[27
]}

Lessi, F. ^{[28
]}

Vallero, S. ^{[29
]}

Zama, D. ^{[30
]}

Cesaro, S. ^{[31
]}

De Paolis, M. R. ^{[32
]}

Facchini, L. ^{[33
]}

Muggeo, P. ^{[34
]}

Offidani, M. ^{[35
]}

Perruccio, K. ^{[36
]}

Russo, D. ^{[37
]}

机构：

[1] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Sci Radiol Radioterapiche & Ematol, Rome, Italy

[2] IRCCS Regina Elena Natl Canc Inst, Hematol & Stem Cell Transplant Unit, Rome, Italy

[3] Azienda Sanit Univ Integrata Udine, Cent Trapianti & Terapie Cellulari, Clin Ematol, Udine, Italy

[4] Spedali Civil Brescia, Hematol, Brescia, Italy

[5] ASST Grande Osped Metropolitano Niguarda, Hematol, Milan, Italy

[6] Azienda Osped San Giovanni Addolorata, Dept Hematol, Rome, Italy

[7] Univ Milano Bicocca, Osped San Gerardo, Ematol Adulti & CTA ASST Monza, Monza, Italy

[8] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Hematol, Milan, Italy

[9] Univ Bologna, Policlin S Orsola Malpighi, Dept Oncohematol, Bologna, Italy

[10] Univ Roma Tor Vergata, Hematol, Rome, Italy

[11] AOU Federico II Napoli, Dept Adv Biomed Sci, Naples, Italy

[12] Univ Cattolica Sacro Cuore, Fdn Policlin A Gemelli IRCCS, Dept Infect Dis, Rome, Italy

[13] Univ Parma, Hematol, Parma, Italy

[14] Osped La Molinette Torino, Dept Hematol, Turin, Italy

[15] Univ Cattolica Sacro Cuore, Fdn Policlin A Gemelli IRCCS, Dipartimento Sci Radiol Radioterapiche & Ematol, Rome, Italy

[16] Univ Perugia, Osped Santa Maria Misericorda, Dept Hematol, Perugia, Italy

[17] Azienda Osped Univ Policlin Bari, UO Ematol Trapianto, Dipartimento Emergenza & Trapianti Organo, Bari, Italy

[18] Univ Verona, Dept Hematol, Verona, Italy

[19] Fdn IRCSS S Matteo Pavia, Dept Hematol, Pavia, Italy

[20] Dept Pediat Oncohematol, Pavia, Italy

[21] Univ Parma, Dept Hematol, Parma, Italy

[22] Univ Parma, Transplant Unit, Parma, Italy

[23] Azienda Osped Univ Pisana, Pisa, Italy

[24] Osped Reggio Calabria, Dept Hematol, Reggio Di Calabria, Italy

[25] Univ Cagliari, Dept Hematol, Cagliari, Italy

[26] Dept Pediat Oncohematol Padova, Padua, Italy

[27] Univ Firenze, Dept Hematol, Florence, Italy

[28] Dept Hematol, Padua, Italy

[29] Dept Pediat Oncohematol St Anna Torino, Turin, Italy

[30] Dept Pediat Oncohematol, Bologna, Italy

[31] Azienda Ospedal Verona, Dept Pediat Oncohematol, Verona, Italy

[32] Osped Lecce, Dept Hematol, Lecce, Italy

[33] AUSL IRCCS Reggio Emilia, Hematol, Reggio Emilia, Italy

[34] Dept Pediat Oncohematol, Bari, Italy

[35] Univ Ancona, Dept Hematol, Ancona, Italy

[36] Dept Pediat Oncohematol, Perugia, Italy

[37] Dept Hematol, Transplant Unit, Brescia, Italy

来源：

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION | 2019年 / 49卷 / 05期

关键词：

acute leukaemias; candidemia; fungaemia; CLINICAL CHARACTERISTICS; EUROPEAN ORGANIZATION; CANDIDEMIA; EPIDEMIOLOGY; CANDIDAEMIA; INFECTIONS; MULTICENTER; THERAPY; COHORT; RISK;

D O I：

10.1111/eci.13083

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Fungal infections are still a relevant challenge for clinicians involved in the cure of patients with cancer. We retrospectively reviewed charts of hospitalized patients with haematological malignancies (HMs), in which a documented fungaemia was diagnosed between January 2011 and December 2015 at 28 adult and 6 paediatric Italian Hematology Departments. Methods: During the study period, we recorded 215 fungal bloodstream infections (BSI). Microbiological analyses documented that BSI was due to moulds in 17 patients (8%) and yeasts in 198 patients (92%), being Candida spp identified in 174 patients (81%). Results: Mortality rates were 70% and 39% for mould and yeast infections, respectively. Infection was the main cause of death in 53% of the mould and 18% of yeast groups. At the multivariate analysis, ECOG >= 2 and septic shock were significantly associated with increased mortality, and removal of central venous catheter ( CVC) survival was found to be protective. When considering patients with candidemia only, ECOG >= 2 and removal of CVC were statistically associated with overall mortality. Conclusions: Although candidemia represents a group of BSI with a good prognosis, its risk factors largely overlap with those identified for all fungaemias, even though the candidemia-related mortality is lower when compared to other fungal BSI. Management of fungal BSI is still a complex issue, in which both patients and disease characteristics should be focused to address a personalized approach.

引用

页数：10

共 22 条

[1] Epidemiology of candidemia in patients with hematologic malignancies and solid tumours in Brazil [J].