Purpose: We compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs). Methods: Prospective surveillance (2009-2011) of proven and probable FFIs was implemented in 23 Italian hospitals. Results: Out of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1% for HAEs, 56.3% for non-HAEs), and the localization was principally pulmonary (83.2% for HAEs, 74.8% for non-HAEs). Neutropenia was a risk factor for 89.4% HAEs; the main underlying condition was corticosteroid treatment (52.9%) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1%). The overall mortality rate was 44.2% among the HAEs and 35.3% among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1% for HAEs, 77.8% for non- HAEs). Conclusions: The epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients' setting. © The Author(s) 2013.
SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients / Montagna, M. T.; Lovero, G.; Coretti, C.; Martinelli, D.; Delia, M.; De Giglio, O.; Caira, M.; Puntillo, F.; D'Antonio, D.; Venditti, M.; Sambri, V.; Di Bernardo, F.; Barbui, A.; Lo Cascio, G.; Concia, E.; Mikulska, M.; Viscoli, C.; Maximova, N.; Candoni, A.; Oliveri, S.; Lombardi, G.; Pitzurra, L.; Sanguinetti, M.; Masciari, R.; Santantonio, T.; Andreoni, S.; Barchiesi, F.; Pecile, P.; Farina, C.; Viale, P.; Specchia, G.; Caggiano, G.; Pagano, L.. - In: INFECTION. - ISSN 0300-8126. - 42:1(2014), pp. 141-151. [10.1007/s15010-013-0539-3]
SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients
Candoni A.;
2014
Abstract
Purpose: We compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs). Methods: Prospective surveillance (2009-2011) of proven and probable FFIs was implemented in 23 Italian hospitals. Results: Out of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1% for HAEs, 56.3% for non-HAEs), and the localization was principally pulmonary (83.2% for HAEs, 74.8% for non-HAEs). Neutropenia was a risk factor for 89.4% HAEs; the main underlying condition was corticosteroid treatment (52.9%) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1%). The overall mortality rate was 44.2% among the HAEs and 35.3% among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1% for HAEs, 77.8% for non- HAEs). Conclusions: The epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients' setting. © The Author(s) 2013.File | Dimensione | Formato | |
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