Epidemiology and outcome of fungemia in a cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031)
Autor: | Cornely, O. A., Gachot, B., Akan, H., Bassetti, M., Uzun, O., Kibbler, C., Marchetti, O., De Burghgraeve, P., Ramadan, S., Pylkkanen, L., Ameye, L., Paesmans, M., Donnelly, P. J., Kibbler, C. C., Bille, J. |
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Přispěvatelé: | EORTC Infectious Diseases Group, Cornely, OA., Gachot, B., Akan, H., Bassetti, M., Uzun, O., Kibbler, CC., Marchetti, O., Bille, J., de Burghgraeve, P., Pylkkanen, L., Ameye, L., Paesmans, M., Donnelly, PJ., İç Hastalıkları |
Jazyk: | angličtina |
Rok vydání: | 2015 |
Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Antifungal Agents Adolescent Aged Aged 80 and over Candida Female Fungemia/complications Fungemia/epidemiology Humans Immunocompromised Host Kaplan-Meier Estimate Leukemia/complications Leukemia/epidemiology Middle Aged Prospective Studies Shock Septic Young Adult Population Immunology Microbiology Internal medicine 80 and over medicine cancer Intensive care medicine education Prospective cohort study Survival rate Fungemia education.field_of_study Leukemia Septic business.industry Incidence (epidemiology) candidemia Cancer candida leukemia Shock Odds ratio medicine.disease Infectious Diseases Cohort business Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5] |
Zdroj: | Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, vol. 61, no. 3, pp. 324-331 Clinical Infectious Diseases, 61, 324-31 Clinical Infectious Diseases, 61, 3, pp. 324-31 |
ISSN: | 1058-4838 |
Popis: | Item does not contain fulltext BACKGROUND: Anti-cancer treatment and the cancer population have evolved since the last European Organisation for Research and Treatment of Cancer (EORTC) fungemia survey, and there are few recent large epidemiological studies. METHODS: This was a prospective cohort study including 145 030 admissions of patients with cancer from 13 EORTC centers. Incidence, clinical characteristics, and outcome of fungemia were analyzed. RESULTS: Fungemia occurred in 333 (0.23%; 95% confidence interval [CI], .21-.26) patients, ranging from 0.15% in patients with solid tumors to 1.55% in hematopoietic stem cell transplantation recipients. In 297 evaluable patients age ranged from 17 to 88 years (median 56 years), 144 (48%) patients were female, 165 (56%) had solid tumors, and 140 (47%) had hematological malignancies. Fungemia including polymicrobial infection was due to: Candida spp. in 267 (90%), C. albicans in 128 (48%), and other Candida spp. in 145 (54%) patients. Favorable overall response was achieved in 113 (46.5%) patients by week 2. After 4 weeks, the survival rate was 64% (95% CI, 59%-70%) and was not significantly different between Candida spp. Multivariable logistic regression identified baseline septic shock (odds ratio [OR] 3.04, 95% CI, 1.22-7.58) and tachypnoea as poor prognostic factors (OR 2.95, 95% CI, 1.66-5.24), while antifungal prophylaxis prior to fungemia (OR 0.20, 95% CI, .06-.62) and remission of underlying cancer (OR, 0.18; 95% CI, .06-.50) were protective. CONCLUSIONS: Fungemia, mostly due to Candida spp., was rare in cancer patients from EORTC centers but was associated with substantial mortality. Antifungal prophylaxis and remission of cancer predicted better survival. |
Databáze: | OpenAIRE |
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