Epidemiology of Fungal Infections in Hematological Malignancies in Italy: SEIFEM-2004 Study (Sorveglianza Epidemiologica Infezioni Fungine Nelle Emopatie Maligne).

Author:

Pagano Livio12,Caira Morena12,Candoni Anna32,Offidani Massimo42,Martino Bruno52,Liso Vincenzo62,Picardi Marco72,Bonini Alessandro82,Chierichini Anna92,Fanci Rossella102,Caramatti Cecilia112,Invernizzi Rosangela122,Gallamini Andrea132,Mitra Maria Enza142,Melillo Lorella152,Allione Bernardino162,Fianchi Luana12,Falcucci Paolo12,Valentini Caterina Giovanna12,Van Lint Maria Teresa172,Girmenia Corrado182,Nosari Anna Maria192

Affiliation:

1. Hematology, Catholic University, Rome, Italy

2. (Intr. by Giuseppe Leone)

3. Hematology, Udine University

4. Hematology, Ancona University

5. Hematology, Reggio Calabria Hospital

6. Hematology, Bari University

7. Hematology, Federico II University, Napoli

8. Hematology, Reggio Emilia Hospital

9. Hematology, San Giovanni Addolorata Hospital, Rome

10. Hematology, Firenze University

11. Hematology, Parma University

12. Hematology, San Matteo Hospital, Pavia

13. Cuneo Hospital

14. Hematology, Palermo University

15. Hematology, S. Giovanni Rotondo Hospital

16. Hematology, Alessandria Hospital

17. Hematology, San Martino Hospital, Genova

18. Hematology, La Sapienza University, Rome

19. Hematology, Niguarda Hospital, Milano

Abstract

Abstract Background: To evaluate the incidence and the outcome of fungal infections in patients (pts) affected by hematological malignancies (HM). Methods: A retrospective study, conducted over 1999–2003, in pts with HM, admitted in 18 Italian Hematology divisions in tertiary cares or university hospitals, who developed proven or probable fungal infections. Results: The population included 11,802 pts: 3,012 AML (25.5%), 1,173 ALL (9.9%), 596 CML (5%), 1,104 CLL (9.4%), 1,616 MM (13.7%), 3,457 NHL (29.3%), 844 HL (7.2%). Pts who underwent HSCT were included in a different analysis. A fungal infection occurred in 538 pts, with an incidence of 4.6%; in particular we registered 346 episodes sustained by moulds (incidence 2.9%) and 193 by yeasts (1.6%). The incidence rate depends upon underlying malignancy (12.3% in AML, 6.5% in ALL, 2.7% in CML, 0.6% in CLL, 0.5% in MM, 1.6% in NHL, 0.9% in HL). Among moulds, the etiological agents were Aspergillus (310 episodes, incidence 2.8%), Mucorales (13 pts, 0.1%), Fusarium (15 pts, 0.1%), and other rare fungi (7 pts, 0.1%). Among yeasts we registered septicemia due to Candida (175 pts, 1.6%). Other yeast infections were caused by Cryptococcus (8 pts, 0.1%), Tricosporon (7 pts, 0.1%) and other rare agents (2 pts). We did not observed an increase of A.terreus infections while the number of episodes sustained by A.flavus increased from 1999 to 2003 (RR 2.10; IC95% 0.8–5.49; p-value 0.117). The overall mortality rate was 1.8%. Among 538 pts with fungal infection 39% died for this complication, with differences between aspergillosis (42%), zygomycosis (63%), fusariosis (53%) and candidemia (33%). There was not variation in mortality rate during the study period; comparing these pts with those observed in our previous studies during the period 1987–1988 we observed a significant reduction of death due to aspergillosis (RR 1.90; IC 95% 1.17–3.09), but no differences in mortality rate due to Candida. Conclusions: Our study confirms the general trends already described: infections due to moulds are more frequent than those caused by yeast. Aspergillus remains the main etiologic agent, followed by Candida. The other agents (Mucorales, Fusarium, Trichosporon) remain rare. AML represents the most frequently involved category. The mortality rate due to aspergillosis is actually about 40%, with a remarkable decrease when compared to past years; as for candidemia, we observed a reduction in the incidence, but not in the mortality rate.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3