Autor: |
Vargas-Espíndola LA; Facultad de Medicina, Universidad Nacional de Colombia, Bogota 111321, Colombia.; Infectious Diseases Group, Instituto Nacional de Cancerología, Bogota 111511, Colombia., Cuervo-Maldonado SI; Facultad de Medicina, Universidad Nacional de Colombia, Bogota 111321, Colombia.; Infectious Diseases Group, Instituto Nacional de Cancerología, Bogota 111511, Colombia.; GREICAH-Grupo de Investigacion Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas, Bogotá 111321, Colombia., Enciso-Olivera JL; Facultad de Medicina, Universidad Nacional de Colombia, Bogota 111321, Colombia., Gómez-Rincón JC; Infectious Diseases Group, Instituto Nacional de Cancerología, Bogota 111511, Colombia., Jiménez-Cetina L; Microbiology Laboratory, Instituto Nacional de Cancerología, Bogota 111511, Colombia., Sánchez-Pedraza R; Facultad de Medicina, Universidad Nacional de Colombia, Bogota 111321, Colombia.; GREICAH-Grupo de Investigacion Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas, Bogotá 111321, Colombia., García-Guzmán K; Infectious Diseases Group, Instituto Nacional de Cancerología, Bogota 111511, Colombia.; GREICAH-Grupo de Investigacion Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas, Bogotá 111321, Colombia., López-Mora MJ; Clínica de Marly, Bogota 110231, Colombia., Álvarez-Moreno CA; Fundación Sanitas, Clínica Colombia, Bogotá 111221, Colombia., Cortés JA; Facultad de Medicina, Universidad Nacional de Colombia, Bogota 111321, Colombia., Garzón-Herazo JR; Hospital Universitario San Ignacio, Bogotá 110231, Colombia., Martínez-Vernaza S; Hospital Universitario San Ignacio, Bogotá 110231, Colombia., Sierra-Parada CR; Laboratorio Clínico y de Patología, Clínica Colsanitas, Grupo Keralty, Bogotá 111221, Colombia., Murillo-Sarmiento BA; Infectious Diseases Group, Instituto Nacional de Cancerología, Bogota 111511, Colombia. |
Abstrakt: |
Fungemia in hematologic malignancies (HM) has high mortality. This is a retrospective cohort of adult patients with HM and fungemia between 2012 and 2019 in institutions of Bogotá, Colombia. The epidemiological, clinical, and microbiological characteristics are described, and risk factors related to mortality are analyzed. One hundred five patients with a mean age of 48 years (SD 19.0) were identified, 45% with acute leukemia and 37% with lymphomas. In 42%, the HM was relapsed/refractory, 82% ECOG > 3, and 35% received antifungal prophylaxis; 57% were in neutropenia, with an average duration of 21.8 days. In 86 (82%) patients, Candida spp. was identified, and other yeasts in 18%. The most frequent of the isolates were non-albicans Candida (61%), C. tropicalis (28%), C. parapsilosis (17%), and C. krusei (12%). The overall 30-day mortality was 50%. The survival probability at day 30 in patients with leukemia vs. lymphoma/multiple myeloma (MM0 group was 59% (95% CI 46-76) and 41% (95% CI 29-58), p = 0.03, respectively. Patients with lymphoma or MM (HR 1.72; 95% CI 0.58-2.03) and ICU admission (HR 3.08; 95% CI 1.12-3.74) were associated with mortality. In conclusion, in patients with HM, non-albicans Candida species are the most frequent, and high mortality was identified; moreover, lymphoma or MM and ICU admission were predictors of mortality. |