Abstract

Background: Fungal infections are still a relevant challenge for clinicians involved in the cure of patients with cancer. We retrospectively reviewed charts of hospitalized patients with haematological malignancies (HMs), in which a documented fungaemia was diagnosed between January 2011 and December 2015 at 28 adult and 6 paediatric Italian Hematology Departments. Methods: During the study period, we recorded 215 fungal bloodstream infections (BSI). Microbiological analyses documented that BSI was due to moulds in 17 patients (8%) and yeasts in 198 patients (92%), being Candida spp identified in 174 patients (81%). Results: Mortality rates were 70% and 39% for mould and yeast infections, respectively. Infection was the main cause of death in 53% of the mould and 18% of the yeast groups. At the multivariate analysis, ECOG ≥ 2 and septic shock were significantly associated with increased mortality, and removal of central venous catheter (CVC) survival was found to be protective. When considering patients with candidemia only, ECOG ≥ 2 and removal of CVC were statistically associated with overall mortality. Conclusions: Although candidemia represents a group of BSI with a good prognosis, its risk factors largely overlap with those identified for all fungaemias, even though the candidemia-related mortality is lower when compared to other fungal BSI. Management of fungal BSI is still a complex issue, in which both patients and disease characteristics should be focused to address a personalized approach.

Original languageEnglish
Article numbere13083
JournalEuropean Journal of Clinical Investigation
Volume49
Issue number5
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Fungemia
Hematologic Neoplasms
Yeast
Catheters
Mycoses
Candidemia
Pediatrics
Candida
Fungi
Central Venous Catheters
Mortality
Yeasts
Infection
Hematology
Septic Shock
Surveys and Questionnaires
Cause of Death
Multivariate Analysis

Keywords

  • acute leukaemias
  • candidemia
  • fungaemia

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry

Cite this

the SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie) (2019). Fungaemia in haematological malignancies: SEIFEM-2015 survey. European Journal of Clinical Investigation, 49(5), [e13083]. https://doi.org/10.1111/eci.13083

Fungaemia in haematological malignancies : SEIFEM-2015 survey. / the SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie).

In: European Journal of Clinical Investigation, Vol. 49, No. 5, e13083, 01.01.2019.

Research output: Contribution to journalArticle

the SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie) 2019, 'Fungaemia in haematological malignancies: SEIFEM-2015 survey', European Journal of Clinical Investigation, vol. 49, no. 5, e13083. https://doi.org/10.1111/eci.13083
the SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie). Fungaemia in haematological malignancies: SEIFEM-2015 survey. European Journal of Clinical Investigation. 2019 Jan 1;49(5). e13083. https://doi.org/10.1111/eci.13083
the SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie). / Fungaemia in haematological malignancies : SEIFEM-2015 survey. In: European Journal of Clinical Investigation. 2019 ; Vol. 49, No. 5.
@article{4e1d4a2132614d38a6bb1297b172b7e5,
title = "Fungaemia in haematological malignancies: SEIFEM-2015 survey",
abstract = "Background: Fungal infections are still a relevant challenge for clinicians involved in the cure of patients with cancer. We retrospectively reviewed charts of hospitalized patients with haematological malignancies (HMs), in which a documented fungaemia was diagnosed between January 2011 and December 2015 at 28 adult and 6 paediatric Italian Hematology Departments. Methods: During the study period, we recorded 215 fungal bloodstream infections (BSI). Microbiological analyses documented that BSI was due to moulds in 17 patients (8{\%}) and yeasts in 198 patients (92{\%}), being Candida spp identified in 174 patients (81{\%}). Results: Mortality rates were 70{\%} and 39{\%} for mould and yeast infections, respectively. Infection was the main cause of death in 53{\%} of the mould and 18{\%} of the yeast groups. At the multivariate analysis, ECOG ≥ 2 and septic shock were significantly associated with increased mortality, and removal of central venous catheter (CVC) survival was found to be protective. When considering patients with candidemia only, ECOG ≥ 2 and removal of CVC were statistically associated with overall mortality. Conclusions: Although candidemia represents a group of BSI with a good prognosis, its risk factors largely overlap with those identified for all fungaemias, even though the candidemia-related mortality is lower when compared to other fungal BSI. Management of fungal BSI is still a complex issue, in which both patients and disease characteristics should be focused to address a personalized approach.",
keywords = "acute leukaemias, candidemia, fungaemia",
author = "{the SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie)} and Marianna Criscuolo and Francesco Marchesi and Anna Candoni and Chiara Cattaneo and Annamaria Nosari and Barbara Veggia and Luisa Verga and Nicola Fracchiolla and Nicola Vianelli and {Del Principe}, {Maria Ilaria} and Marco Picardi and Mario Tumbarello and Franco Aversa and Alessandro Busca and Livio Pagano and Giulia Dragonetti and Stelvio Ballanti and Mario Delia and Gianpaolo Nadali and M. Scium{\`e} and C. Castagnola and A. Ferrari and V. Mancini and N. Decembrino and A. Spolzino and L. Iovino and B. Martino and A. Vacca and E. Calore and R. Fanci and F. Lessi and S. Vallero and D. Zama and S. Cesaro and {De Paolis}, {M. R.} and L. Facchini and P. Muggeo and M. Offidani and K. Perruccio and D. Russo",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/eci.13083",
language = "English",
volume = "49",
journal = "European Journal of Clinical Investigation",
issn = "0014-2972",
publisher = "Blackwell Publishing Ltd",
number = "5",

}

TY - JOUR

T1 - Fungaemia in haematological malignancies

T2 - SEIFEM-2015 survey

AU - the SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie)

AU - Criscuolo, Marianna

AU - Marchesi, Francesco

AU - Candoni, Anna

AU - Cattaneo, Chiara

AU - Nosari, Annamaria

AU - Veggia, Barbara

AU - Verga, Luisa

AU - Fracchiolla, Nicola

AU - Vianelli, Nicola

AU - Del Principe, Maria Ilaria

AU - Picardi, Marco

AU - Tumbarello, Mario

AU - Aversa, Franco

AU - Busca, Alessandro

AU - Pagano, Livio

AU - Dragonetti, Giulia

AU - Ballanti, Stelvio

AU - Delia, Mario

AU - Nadali, Gianpaolo

AU - Sciumè, M.

AU - Castagnola, C.

AU - Ferrari, A.

AU - Mancini, V.

AU - Decembrino, N.

AU - Spolzino, A.

AU - Iovino, L.

AU - Martino, B.

AU - Vacca, A.

AU - Calore, E.

AU - Fanci, R.

AU - Lessi, F.

AU - Vallero, S.

AU - Zama, D.

AU - Cesaro, S.

AU - De Paolis, M. R.

AU - Facchini, L.

AU - Muggeo, P.

AU - Offidani, M.

AU - Perruccio, K.

AU - Russo, D.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Fungal infections are still a relevant challenge for clinicians involved in the cure of patients with cancer. We retrospectively reviewed charts of hospitalized patients with haematological malignancies (HMs), in which a documented fungaemia was diagnosed between January 2011 and December 2015 at 28 adult and 6 paediatric Italian Hematology Departments. Methods: During the study period, we recorded 215 fungal bloodstream infections (BSI). Microbiological analyses documented that BSI was due to moulds in 17 patients (8%) and yeasts in 198 patients (92%), being Candida spp identified in 174 patients (81%). Results: Mortality rates were 70% and 39% for mould and yeast infections, respectively. Infection was the main cause of death in 53% of the mould and 18% of the yeast groups. At the multivariate analysis, ECOG ≥ 2 and septic shock were significantly associated with increased mortality, and removal of central venous catheter (CVC) survival was found to be protective. When considering patients with candidemia only, ECOG ≥ 2 and removal of CVC were statistically associated with overall mortality. Conclusions: Although candidemia represents a group of BSI with a good prognosis, its risk factors largely overlap with those identified for all fungaemias, even though the candidemia-related mortality is lower when compared to other fungal BSI. Management of fungal BSI is still a complex issue, in which both patients and disease characteristics should be focused to address a personalized approach.

AB - Background: Fungal infections are still a relevant challenge for clinicians involved in the cure of patients with cancer. We retrospectively reviewed charts of hospitalized patients with haematological malignancies (HMs), in which a documented fungaemia was diagnosed between January 2011 and December 2015 at 28 adult and 6 paediatric Italian Hematology Departments. Methods: During the study period, we recorded 215 fungal bloodstream infections (BSI). Microbiological analyses documented that BSI was due to moulds in 17 patients (8%) and yeasts in 198 patients (92%), being Candida spp identified in 174 patients (81%). Results: Mortality rates were 70% and 39% for mould and yeast infections, respectively. Infection was the main cause of death in 53% of the mould and 18% of the yeast groups. At the multivariate analysis, ECOG ≥ 2 and septic shock were significantly associated with increased mortality, and removal of central venous catheter (CVC) survival was found to be protective. When considering patients with candidemia only, ECOG ≥ 2 and removal of CVC were statistically associated with overall mortality. Conclusions: Although candidemia represents a group of BSI with a good prognosis, its risk factors largely overlap with those identified for all fungaemias, even though the candidemia-related mortality is lower when compared to other fungal BSI. Management of fungal BSI is still a complex issue, in which both patients and disease characteristics should be focused to address a personalized approach.

KW - acute leukaemias

KW - candidemia

KW - fungaemia

UR - http://www.scopus.com/inward/record.url?scp=85062717222&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062717222&partnerID=8YFLogxK

U2 - 10.1111/eci.13083

DO - 10.1111/eci.13083

M3 - Article

VL - 49

JO - European Journal of Clinical Investigation

JF - European Journal of Clinical Investigation

SN - 0014-2972

IS - 5

M1 - e13083

ER -