SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients

M. T. Montagna, G. Lovero, C. Coretti, D. Martinelli, M. Delia, O. De Giglio, M. Caira, F. Puntillo, D. D'Antonio, M. Venditti, V. Sambri, F. Di Bernardo, A. Barbui, G. Lo Cascio, E. Concia, M. Mikulska, C. Viscoli, N. Maximova, A. Candoni, S. OliveriG. Lombardi, L. Pitzurra, M. Sanguinetti, R. Masciari, T. Santantonio, S. Andreoni, F. Barchiesi, P. Pecile, C. Farina, P. Viale, G. Specchia, G. Caggiano, L. Pagano

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs). Methods: Prospective surveillance (2009-2011) of proven and probable FFIs was implemented in 23 Italian hospitals. Results: Out of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1% for HAEs, 56.3% for non-HAEs), and the localization was principally pulmonary (83.2% for HAEs, 74.8% for non-HAEs). Neutropenia was a risk factor for 89.4% HAEs; the main underlying condition was corticosteroid treatment (52.9%) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1%). The overall mortality rate was 44.2% among the HAEs and 35.3% among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1% for HAEs, 77.8% for non- HAEs). Conclusions: The epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients' setting.

Original languageEnglish
Pages (from-to)141-151
Number of pages11
JournalInfection
Volume42
Issue number1
DOIs
Publication statusPublished - 2014

Keywords

  • Filamentous fungal infections
  • Hematological patients
  • Italian survey
  • Non-hematological patients

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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