المؤلفون: Rebecca van Grootveld, Valentina Masarotto, Peter A. von dem Borne, Nicole M. A. Blijlevens, Dana A. Chitu, Martha T. van der Beek, Marta Fiocco, Mark G. J. de Boer

المصدر: BMC Infectious Diseases, Vol 23, Iss 1, Pp 1-9 (2023)

مصطلحات موضوعية: Aspergillosis, Invasive pulmonary aspergillosis, Invasive fungal infection, Acute myeloid leukaemia, Myelodysplastic syndromes, Aged, Infectious and parasitic diseases, RC109-216

الوصف: Abstract Purpose Study objectives were to estimate the cumulative incidence of death due to different causes of death (CODs) and investigate the effect of invasive aspergillosis (IA) on each separate COD in a cohort of older patients with acute myeloid leukaemia (AML) or high-risk myelodysplastic syndrome (MDS) included in the Haemato-Oncology Foundation for Adults in the Netherlands (HOVON) 43 randomized controlled trial. Methods Pre-collected data from the trial was obtained from the HOVON data center and relevant clinical information was extracted. The cumulative incidence of death due to different CODs was estimated with a competing risk model and the association between each COD and prognostic factors, including IA, were investigated with a cause-specific hazard Cox regression model. Results In total 806 patients were included, mean age of 70 years and 55% were male. The cumulative incidences of death due to leukaemia or infection at 3, 6, 12 and 36 months were 0.06, 0.11, 0.23, 0.42 and 0.17, 0.19, 0.22, 0.25 respectively. Incidence of IA was 21% and diagnosis of IA up until the final chemotherapy cycle was associated with an increased risk of dying from leukaemia (cause-specific hazard ratio (CSHR): 1.75, 95% CI 1.34–2.28) and a trend was seen for infection (CSHR: 1.36, 95% CI 0.96–1.91). Conclusion Leukaemia was the most likely cause of death over time, however in the first year after diagnosis of AML or high-risk MDS infection was the most likely cause of death. Patients with IA had a relatively increased risk of dying from leukaemia or infection.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2334Test

الوصول الحر: https://doaj.org/article/519d33cf622c40b4ab878f981e53f901Test

المؤلفون: Melenotte, Cléa, Aimanianda, Vishukumar, Slavin, Monica, Aguado, José María, Armstrongâ€James, Darius, Chen, Yeeâ€Chun, Husain, Shahid, Van Delden, Christian, Saliba, Faouzi, Lefort, Agnès, Botterel, Francoise, Lortholary, Olivier

المصدر: ISSN: 1398-2273 ; Transplant infectious disease, vol. 25, no. 3 (2023) e14049.

مصطلحات موضوعية: info:eu-repo/classification/ddc/616, Aspergillus, Aspergillus fumigatus, Aspergillosis, Azoles, Children, Drug interaction, Immune reconstitution syndrome, Immunosuppression, Invasive fungal infection, Liver transplant, Prophylaxis, Solid organ transplant, Transplantation, Treatment, Voriconazole

الوصف: Background Liver transplantation is increasing worldwide with underlying pathologies dominated by metabolic and alcoholic diseases in developed countries. Methods We provide a narrative review of invasive aspergillosis (IA) in liver transplant (LT) recipients. We searched PubMed and Google Scholar for references without language and time restrictions. Results The incidence of IA in LT recipients is low (1.8%), while mortality is high (∼50%). It occurs mainly early (<3 months) after LT. Some risk factors have been identified before (corticosteroid, renal, and liver failure), during (massive transfusion and duration of surgical procedure), and after transplantation (intensive care unit stay, reâ€transplantation, reâ€operation). Diagnosis can be difficult and therefore requires full radiological and clinicobiological collaboration. Accurate identification of Aspergillus species is recommended due to the cryptic species, and susceptibility testing is crucial given the increasing resistance of Aspergillus fumigatus to azoles. It is recommended to reduce the dose of tacrolimus (50%) and to closely monitor the trough level when introducing voriconazole, isavuconazole, and posaconazole. Surgery should be discussed on a caseâ€byâ€case basis. Antifungal prophylaxis is recommended in highâ€risk patients. Environmental preventative measures should be implemented to prevent outbreaks of nosocomial aspergillosis in LT recipient units. Conclusion IA remains a very serious disease in LT patients and should be promptly sought and, if possible, prevented by clinicians when risk factors are identified. image

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/36929539; https://archive-ouverte.unige.ch/unige:174839Test; unige:174839

الإتاحة: https://doi.org/10.1111/tid.14049Test
https://archive-ouverte.unige.ch/unige:174839Test

المؤلفون: Jens Martin Poth, Jens-Christian Schewe, Felix Lehmann, Johannes Weller, Mathias Willem Schmandt, Stefan Kreyer, Stefan Muenster, Christian Putensen, Stefan Felix Ehrentraut

المصدر: Journal of Fungi; Volume 9; Issue 7; Pages: 751

مصطلحات موضوعية: invasive fungal disease (IFD), invasive fungal infection (IFI), extracorporeal membrane oxygenation (ECMO), candidemia, aspergillosis, COVID-19, SARS-CoV2

جغرافية الموضوع: agris

الوصف: Invasive fungal disease (IFD) is associated with the mortality of patients on extracorporeal membrane oxygenation (ECMO). Several risk factors for IFD have been identified in patients with or without ECMO. Here, we assessed the relevance of coronavirus disease (COVID-19) for the occurrence of IFD in patients on veno-venous (V-V) ECMO for respiratory failure. In a retrospective analysis of all ECMO cases between January 2013 and December 2022 (2020–2022 for COVID-19 patients), active COVID-19 and the type, timing and duration of IFD were investigated. Demographics, hospital, ICU length of stay (LoS), duration of ECMO, days on invasive mechanical ventilation, prognostic scores (Respiratory ECMO Survival Prediction (RESP) score, Charlson Comorbidity Index (CCI), Therapeutic Intervention Scoring System (TISS)-10, Sequential Organ Failure Assessment (SOFA) score and Simplified Acute Physiology Score (SAPS)-II) and length of survival were assessed. The association of COVID-19 with IFD was investigated using propensity score matching and uni- and multivariable logistic regression analyses. We identified 814 patients supported with ECMO, and 452 patients were included in further analyses. The incidence of IFD was 4.8% and 11.0% in patients without and with COVID-19, respectively. COVID-19 status represented an independent risk factor for IFD (OR 4.30; CI 1.72–10.85; p: 0.002; multivariable regression analysis). In patients with COVID-19, 84.6% of IFD was candidemia and 15.4% represented invasive aspergillosis (IA). All of these patients died. In patients on V-V ECMO, we report that COVID-19 is an independent risk factor for IFD, which is associated with a detrimental prognosis. Further studies are needed to investigate strategies of antifungal therapy or prophylaxis in these patients.

وصف الملف: application/pdf

العلاقة: Fungal Pathogenesis and Disease Control; https://dx.doi.org/10.3390/jof9070751Test

الإتاحة: https://doi.org/10.3390/jof9070751Test

المؤلفون: Stephanie R. Earnshaw, Cheryl McDade, Andrew Bryan, Monica Ines, Christianne Micallef, Anita Sung, David A. Enoch

المصدر: Microbiology Spectrum, Vol 10, Iss 3 (2022)

مصطلحات موضوعية: antifungal, aspergillosis, cost-effectiveness, economic evaluation, healthcare costs, invasive fungal infection, Microbiology, QR1-502

الوصف: ABSTRACT A diagnostic-driven (DD) treatment strategy has proven successful for treating invasive fungal infections (IFIs) caused by Aspergillus. However, uptake of this treatment strategy is not fully embraced. This study compares the economic and clinical impact of DD and empirical-treatment (ET) strategies used within hospitals. Methods: a decision-analytic model was developed to compare costs and clinical outcomes associated with ET or a DD strategy of identifying infections caused by Aspergillus via galactomannan-antigen testing or Aspergillus polymerase chain reaction (PCR) in neutropenic patients with unexplained fever. Patients were treated prophylactically with antifungal treatments as seen in United Kingdom (UK) hospitals. The IFI incidence, response, mortality, resource use, and adverse events were obtained from meta-analyses and other clinical studies. Analyses were performed from the U.K. hospital perspective, and costs were obtained from standard costing sources. Although diagnostic-testing costs increased, total cost and length of stay were reduced by £1,121 and 1.54 days when treating via a DD strategy. Intensive care and general ward days accounted for > 40% of total costs and > 58% of the cost reduction came from reduced antifungal costs. Treating with a DD strategy reduced the number of patients being treated with antifungal agents while survival was increased. Thus, a DD strategy was cost savings (-£136,787 cost per death avoided) compared with an ET strategy. Conclusion: this study suggests that incorporating a DD strategy as the preferred treatment protocol may be a cost-saving and clinically improved treatment strategy for managing neutropenic patients with unexplained fever. IMPORTANCE Patients at risk of invasive fungal infections (IFIs), such as Aspergillus spp., tend to be immunocompromised and usually take several medications which may generate many side effects. Prescribing is further complicated by comorbidities, drug interactions and challenges accessing diagnostics. Therefore, adding another agent may be neither straightforward nor the best option for these types of patients. A diagnostic-driven (DD) treatment strategy has proven successful for treating IFIs. However, uptake of this treatment strategy is not fully embraced in clinical practice perhaps because this strategy is thought to be more costly and/or to result in higher mortality relative to treating empirically. We developed a decision-analytic model to examine the impact of these 2 strategies on costs and health outcomes. This study indicates that incorporating a DD strategy as the preferred treatment protocol may be a cost-saving and clinically improved treatment strategy for managing neutropenic patients with unexplained fever.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2165-0497Test

الوصول الحر: https://doaj.org/article/37fc7ab13eeb4247bcffc19ce480d023Test

المؤلفون: Nadir Ullah, Chiara Sepulcri, Malgorzata Mikulska

المصدر: Journal of Fungi; Volume 8; Issue 7; Pages: 674

مصطلحات موضوعية: isavuconazole, CAPA, CAM, invasive fungal infection, COVID-19, aspergillosis, mucormycosis, RRT, ECMO, TDM

جغرافية الموضوع: agris

الوصف: Isavuconazole is a broad-spectrum antifungal drug recently approved as a first-line treatment for invasive aspergillosis and as a first or alternative treatment for mucormycosis. The purpose of this review was to report and discuss the use of isavuconazole for the treatment of COVID-19-associated aspergillosis (CAPA), and COVID-19-associated mucormycosis (CAM). Among all studies which reported treatment of CAPA, approximately 10% of patients were reportedly treated with isavuconazole. Considering 14 identified studies that reported the use of isavuconazole for CAPA, isavuconazole was used in 40% of patients (95 of 235 treated patients), being first-line monotherapy in over half of them. We identified six studies that reported isavuconazole use in CAM, either alone or in combination therapy. Overall, isavuconazole was used as therapy in 13% of treated CAM patients, frequently as combination or sequential therapy. The use of isavuconazole in CAPA and CAM is complicated by the challenge of achieving adequate exposure in COVID-19 patients who are frequently obese and hospitalized in the ICU with concomitant renal replacement therapy (RRT) or extracorporeal membrane oxygenation (ECMO). The presence of data on high efficacy in the treatment of aspergillosis, lower potential for drug–drug interactions (DDIs) and for subtherapeutic levels, and no risk of QT prolongation compared to other mold-active azoles, better safety profile than voriconazole, and the possibility of using an intravenous formulation in the case of renal failure are the advantages of using isavuconazole in this setting.

وصف الملف: application/pdf

العلاقة: Fungal Pathogenesis and Disease Control; https://dx.doi.org/10.3390/jof8070674Test

الإتاحة: https://doi.org/10.3390/jof8070674Test

المؤلفون: Jens Martin Poth, Jens-Christian Schewe, Christian Putensen, Stefan Felix Ehrentraut

المصدر: Journal of Clinical Medicine; Volume 11; Issue 7; Pages: 1940

مصطلحات موضوعية: invasive fungal disease (IFD), invasive fungal infection, extracorporeal membrane oxygenation (ECMO), acute respiratory distress syndrome (ARDS), candidiasis, candidemia, aspergillosis, bloodstream infection (BSI)

الوصف: Objective: To assess the incidence and significance of invasive fungal diseases (IFD) during veno-venous (VV) ECMO support for acute respiratory distress syndrome (ARDS). Methods: Retrospective analysis from January 2013 to April 2021 of all ECMO cases for ARDS at a German University Hospital. In patients with IFD (IFD patients), type of IFD, time of IFD, choice of antifungal agent, duration, and success of therapy were investigated. For comparison, patients without IFD (non-IFD patients) were selected by propensity score matching using treatment-independent variables (age, gender, height, weight, and the Sequential Organ Failure Assessment (SOFA) score at ICU admission). Demographics, hospital and ICU length of stay, duration of ECMO therapy, days on mechanical ventilation, prognostic scores (Charlson Comorbidity Index (CCI), Therapeutic Intervention Scoring System (TISS), and length of survival were assessed. Results: A total of 646 patients received ECMO, 368 patients received VV ECMO. The incidence of IFD on VV ECMO was 5.98%, with 5.43% for Candida bloodstream infections (CBSI) and 0.54% for invasive aspergillosis (IA). In IFD patients, in-hospital mortality was 81.8% versus 40.9% in non-IFD patients. The hazard ratio for death was 2.5 (CI 1.1–5.4; p: 0.023) with IFD. Conclusions: In patients on VV ECMO for ARDS, about one in 17 contracts an IFD, with a detrimental impact on prognosis. Further studies are needed to address challenges in the diagnosis and treatment of IFD in this population.

وصف الملف: application/pdf

العلاقة: Emergency Medicine; https://dx.doi.org/10.3390/jcm11071940Test

الإتاحة: https://doi.org/10.3390/jcm11071940Test

المؤلفون: Yan, C.G., Hao, P., Wu, G.Y., Lin, J., Xu, J., Zhang, T.J., Li, X.Y., Li, H.X., Wang, S.B., Xu, Y.K., Woodruff, H.C., Lambin, P.

المصدر: Yan , C G , Hao , P , Wu , G Y , Lin , J , Xu , J , Zhang , T J , Li , X Y , Li , H X , Wang , S B , Xu , Y K , Woodruff , H C & Lambin , P 2022 , ' Machine learning-based combined nomogram for predicting the risk of pulmonary invasive fungal infection in severely immunocompromised patients ' , Annals of translational medicine , vol. 10 , no. 9 , 514 . https://doi.org/10.21037/atm-21-4980Test

مصطلحات موضوعية: ASPERGILLOSIS, BIOMARKER, CT, DIAGNOSIS, DISEASE, IMAGES, Machine learning (ML), RADIOMICS, SURVIVAL, computed tomography (CT), hematologic malignancy, invasive fungal infection (IFI)

الوصف: Background: Early and accurate diagnosis of invasive fungal infection (IFI) is pivotal for the initiation of effective antifungal therapy for patients with hematologic malignancies. Methods: This retrospective study involved 235 patients with hematologic malignancies and pulmonary infections diagnosed as IFIs (n=118) or bacterial pneumonia (n=117). Patients were randomly divided into training (n=188) and validation (n=47) datasets. Four feature selection methods with nine classifiers were implemented to select the optimal machine learning (ML) model using five-fold cross-validation. A radiomic signature was constructed using a linear ML algorithm, and a radiomic score (Radscore) was calculated. The combined model was developed with the Radscore, the significant clinical and radiologic factors were selected using multivariable logistic regression, and the results were presented as a clinical radiomic nomogram. A prospective pilot study was also conducted to compare the classification performance of the combined nomogram with practicing radiologists. Results: Significant differences were found in the Radscore between IFI and bacterial pneumonia patients in the training (0.683 vs. -0.724, P<0.001) and validation set (0.353 vs. -0.717, P=0.002). The combined model showed good discrimination performance in the validation cohort [area under the curve (AUC) =0.844] and outperformed the clinical (AUC =0.696) and radiomics (AUC =0.767) model alone (both P<0.05). Conclusions: The clinical radiomic nomogram can serve as a promising predictive tool for IFI in patients with hematologic malignancies.

العلاقة: https://cris.maastrichtuniversity.nl/en/publications/bd3e36d2-7cd5-43d0-9c13-f32123247472Test

الإتاحة: https://doi.org/10.21037/atm-21-4980Test
https://cris.maastrichtuniversity.nl/en/publications/bd3e36d2-7cd5-43d0-9c13-f32123247472Test

المؤلفون: Shariati A, Moradabadi A, Chegini Z, Khoshbayan A, Didehdar M

المصدر: Infection and Drug Resistance, Vol Volume 13, Pp 2329-2354 (2020)

مصطلحات موضوعية: invasive fungal infection, blood malignancies, aspergillosis, candidiasis, fusariosis, mucormycosis, criptococoosis, trichosporonosis, Infectious and parasitic diseases, RC109-216

الوصف: Aref Shariati,1 Alireza Moradabadi,2 Zahra Chegini,3 Amin Khoshbayan,4 Mojtaba Didehdar2 1Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Department of Medical Parasitology and Mycology, Arak University of Medical Sciences, Arak, Iran; 3Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; 4Student Research Committee, Iran University of Medical Sciences, Tehran, IranCorrespondence: Mojtaba DidehdarDepartment of Medical Parasitology and Mycology, Arak University of Medical Sciences, Arak, IranEmail didehdar_m@Arakmu.ac.irAbstract: In patients with hematologic malignancies due to immune system disorders, especially persistent febrile neutropenia, invasive fungal infections (IFI) occur with high mortality. Aspergillosis, candidiasis, fusariosis, mucormycosis, cryptococcosis and trichosporonosis are the most important infections reported in patients with hematologic malignancies that undergo hematopoietic stem cell transplantation. These infections are caused by opportunistic fungal pathogens that do not cause severe issues in healthy individuals, but in patients with hematologic malignancies lead to disseminated infection with different clinical manifestations. Prophylaxis and creating a safe environment with proper filters and air pressure for patients to avoid contact with the pathogens in the surrounding environment can prevent IFI. Furthermore, due to the absence of specific symptoms in IFI, rapid and accurate diagnosis reduces the mortality rate of these infections and using molecular techniques along with standard mycological methods will improve the diagnosis of disseminated fungal infection in patients with hematologic disorders. Amphotericin B products, extended-spectrum azoles, and echinocandins are the essential drugs to control invasive fungal infections in patients with hematologic malignancies, and according to various conditions of patients, different results of treatment with these drugs have been reported in different studies. On the other hand, drug resistance in recent years has led to therapeutic failures and deaths in patients with blood malignancies, which indicates the need for antifungal susceptibility tests to use appropriate therapies. Life-threatening fungal infections have become more prevalent in patients with hematologic malignancies in recent years due to the emergence of new risk factors, new species, and increased drug resistance. Therefore, in this review, we discuss the different dimensions of the most critical invasive fungal infections in patients with hematologic malignancies and present a list of these infections with different clinical manifestations, treatment, and outcomes.Keywords: invasive fungal infection, blood malignancies, aspergillosis, candidiasis, fusariosis, mucormycosis, cryptococcosis, trichosporonosis

وصف الملف: electronic resource

العلاقة: https://www.dovepress.com/an-overview-of-the-management-of-the-most-importantTest-invasive-fungal-in-peer-reviewed-article-IDR; https://doaj.org/toc/1178-6973Test

الوصول الحر: https://doaj.org/article/da5e5c4a0fc84967b0ff13ae271ecf9dTest

المؤلفون: Souheil Zayet, Aida Zaghdoudi, Lamia Ammari, Badreddine Kilani, Hanene Tiouiri Benaissa

المصدر: IDCases, Vol 23, Iss , Pp e01022- (2021)

مصطلحات موضوعية: Mucormycosis, Aspergillosis, Invasive fungal infection, Rhinosinusitis, Diabetes, Infectious and parasitic diseases, RC109-216

الوصف: Opportunistic fungal infections are life-threatening conditions with a high rate of morality, mostly occurring in immunocompromised hosts. We reported the case of mixed mold infection in a 69 year-old patient with latent diabetes mellitus. She was initially admitted for right orbital cellulitis. Cerebro-rhino-orbital mucormycosis and aspergillosis coinfection was diagnosed from mycological testing and histology after nasal biopsy sample. The patient received amphotericin B deoxycholate then voriconazole combined to surgical debridement with a favorable outcome.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2214250920303309Test; https://doaj.org/toc/2214-2509Test

الوصول الحر: https://doaj.org/article/ad2195af5dd64ec0ad1d873f8638e89bTest

المؤلفون: Helbies Bedier, John Lin, Charles Frenette, Jean-Pierre Routy

المصدر: IDCases, Vol 26, Iss , Pp e01263- (2021)

مصطلحات موضوعية: Invasive fungal infection, Aspergillosis, Bruton’s Tyrosine Kinase Inhibitor, Infectious and parasitic diseases, RC109-216

الوصف: A case of a 67-year-old male with CLL, presented with prolonged pancytopenia after his first cycle of fludarabine, cyclophosphamide, and rituximab (FCR) chemotherapy. He was then treated with ibrutinib oral monotherapy. Shortly after ibrutinib treatment initiation, he developed a brain abscess and pulmonary disease as a part of an invasive aspergillosis. The patient improved after brain abscess drainage and the anti-fungal therapy voriconazole. Upon resuming ibrutinib four months after his hospitalization, he developed extensive acneiform facial lesions. This case is the first to report on the development of two separate complications in one patient related to ibrutinib, namely, Aspergillus infection, and severe acneiform skin lesions.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2214250921002195Test; https://doaj.org/toc/2214-2509Test

الوصول الحر: https://doaj.org/article/428384414548443a8a987be368b263ddTest