Nosocomial breakthrough fungaemia during antifungal prophylaxis or empirical antifungal therapy in 41 cancer patients receiving antineoplastic chemotherapy: analysis of aetiology risk factors and outcome
| Autor: | E. Kukuckova, A. Kunova, J. Trupl, E. Oravcova, K Stopkova-Grey, A. Demitrovicova, Vladimir Krcmery, Stanislav Spanik, K. Kralovicova, M. Mrazova-Studena, I. Krupova |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Microbiology (medical) Slovakia medicine.medical_specialty Antifungal Agents Trichosporon beigelii Antineoplastic Agents Biology Candida parapsilosis Gastroenterology Pichia Candida tropicalis Risk Factors Amphotericin B Neoplasms Candida krusei Internal medicine medicine Humans Pharmacology (medical) Candida albicans Fluconazole Fungemia Retrospective Studies Pharmacology Cross Infection Candida glabrata Incidence Candida lusitaniae Drug Resistance Microbial biology.organism_classification medicine.disease Drug Resistance Multiple Surgery Ketoconazole Treatment Outcome Infectious Diseases Drug Therapy Combination Female Mitosporic Fungi Itraconazole |
| Zdroj: | Journal of Antimicrobial Chemotherapy. 41:373-380 |
| ISSN: | 1460-2091 0305-7453 |
| DOI: | 10.1093/jac/41.3.373 |
| Popis: | Forty-one episodes of breakthrough fungaemia occurring over a 7.5 year period in the National and St Elizabeth's Cancer Institutes in Bratislava, Slovakia, were analysed. Five of them occurred during prophylaxis with fluconazole (one Torulopsis glabrata, one Hansenula anomala, two Candida krusei and one Candida parapsilosis), ten with itraconazole (three Trichosporon pullulans, one Trichosporon beigelii, one Cryptococcus laurentii, three Candida albicans and two T. glabrata), 11 during prophylaxis with ketoconazole (one Candida norvegenesis, one C. parapsilosis, one C. krusei, one Candida tropicalis, five C. albicans, one Candida stellatoidea and one C. laurentii and 15 during empirical therapy with amphotericin B (ten C. albicans, two T. beigelii and three Candida lusitaniae). The most frequent risk factors for breakthrough fungaemia were neutropenia, previous therapy with multiple antibiotics and recent catheter insertion. Comparing these episodes with 38 non-breakthrough fungaemias (appearing at the same institute in the same period) differences in certain risk factors were noted: breakthrough fungaemias were more frequently observed in patients with acute leukaemia (39.0% vs 5.2%, P < 0.001), mucositis (34.2% vs 13.1%, P < 0.05), prophylaxis with quinolones (58.5% vs 15.8%, P < 0.0001) and catheter-associated infections (29.3% vs 2.6%, P < 0.003). In this subgroup overall mortality (36.6% vs 28.8%) or early attributable mortality (22.0% vs 23.6%) were not significantly different. |
| Databáze: | OpenAIRE |
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