Survival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI study.

Autor: Cag Y; Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Kadiköy, Istanbul 34722, Turkey. Electronic address: yasemin.cag@medeniyet.edu.tr., Erdem H; Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, Bahrain., Gunduz M; Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey., Komur S; Department of Infectious Diseases and Clinical Microbiology, Cukurova University, Adana, Turkey., Ankarali H; Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey., Ural S; Department of Infectious Diseases and Clinical Microbiology, İzmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey., Tasbakan M; Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Izmir, Turkey., Tattevin P; Department of Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France., Tombak A; Department of Hematology, Mersin University Faculty of Medicine, Mersin, Turkey., Ozturk-Engin D; Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey., Tartar AS; Department of Infectious Diseases and Clinical Microbiology, Firat University Faculty of Medicine, Elazig, Turkey., Batirel A; Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey., Tekin R; Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey., Duygu F; Department of Infectious Diseases and Clinical Microbiology, Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey., Caskurlu H; Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Kadiköy, Istanbul 34722, Turkey., Kurtaran B; Department of Infectious Diseases and Clinical Microbiology, Cukurova University, Adana, Turkey., Durdu B; Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey., Haciseyitoglu D; Department of Clinical Microbiology, University of Health Sciences Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey., Rello J; Clinical Research and Epidemiology in Pneumonia and Sepsis, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain; Clinical Research, CHRU Nîmes, Nîmes, France.
Jazyk: angličtina
Zdroj: European journal of internal medicine [Eur J Intern Med] 2022 Jun; Vol. 100, pp. 56-61. Date of Electronic Publication: 2022 Mar 15.
DOI: 10.1016/j.ejim.2022.03.008
Abstrakt: Background: Mucormycosis is an emerging aggressive mold infection. This study aimed to assess the outcome of hospitalized adults with rhino-orbito-cerebral mucormycosis (ROCM). The secondary objective was to identify prognostic factors in this setting.
Methods: This study was an international, retrospective, multicenter study. Patients' data were collected from 29 referral centers in 6 countries. All qualified as "proven cases" according to the EORTC/MSGERC criteria.
Results: We included 74 consecutive adult patients hospitalized with ROCM. Rhino-orbito-cerebral type infection was the most common presentation (n = 43; 58.1%) followed by rhino-orbital type (n = 31; 41.9%). Twenty (27%) had acquired nosocomial bacterial infections. A total of 59 (79.7%) patients (16 in combination) received appropriate antifungal treatment with high-doses of liposomal amphotericin B. Fifty-six patients (75.7%) underwent curative surgery. Thirty-five (47.3%) required intensive care unit admission (27; 36.5% under mechanical ventilation). Hospital survival was 56.8%, being reduced to 7.4% in patients with invasive mechanical ventilation. A multivariate binary backward logistic regression model identified confusion at admission (OR 11.48), overlapping hospital-acquired infection (OR 10.27), use of antifungal treatment before diagnosis (OR 10.20), no surgical debridement (OR 5.92), and the absence of prior sinusitis (OR 6.32) were independently associated with increased risk for death.
Conclusion: Today, ROCM still has high mortality rate. Improving source control, rational therpy, and preventing nosocomial infections may improve survival in this severe infection.
(Copyright © 2022. Published by Elsevier B.V.)
Databáze: MEDLINE
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