Fungaemia in haematological malignancies: SEIFEM-2015 survey

SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie)

Research output: Contribution to journalArticle

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
Pages (from-to)e13083
JournalEuropean Journal of Clinical Investigation
Volume49
Issue number5
DOIs
Publication statusPublished - May 2019

    Fingerprint

Keywords

  • Adolescent
  • Adult
  • Aged
  • Candidemia/complications
  • Child
  • Female
  • Fungemia/complications
  • Hematologic Neoplasms/microbiology
  • Humans
  • Italy/epidemiology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Yeasts/isolation & purification
  • Young Adult

Cite this

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