التفاصيل البيبلوغرافية
| العنوان: |
Mucormycosis in intensive care unit: surgery is a major prognostic factor in patients with hematological malignancy. |
| المؤلفون: |
Claustre, Johanna, Larcher, Romaric, Jouve, Thomas, Truche, Anne-Sophie, Nseir, Saad, Cadiet, Julien, Zerbib, Yoann, Lautrette, Alexandre, Constantin, Jean-Michel, Charles, Pierre-Emmanuel, Daubin, Cedric, Coudroy, Remi, Dellamonica, Jean, Argaud, Laurent, Phelouzat, Pierre, Contou, Damien, Pocquet, Juliette, Voiriot, Guillaume, Navellou, Jean-Christophe, Lavagne, Pierre |
| المصدر: |
Annals of Intensive Care; 6/8/2020, Vol. 10 Issue 1, p1-12, 12p |
| مصطلحات موضوعية: |
HEMATOLOGIC malignancies, INTENSIVE care units, MUCORMYCOSIS, ANTIFUNGAL agents, MYCOSES |
| مستخلص: |
Background: Mucormycosis is an invasive fungal infection, with an increasing incidence especially in patients with hematological malignancies. Its prognosis is poor because of its high invasive power and its intrinsic low susceptibility to antifungal agents. We aimed to describe the epidemiology of mucormycosis in intensive care units (ICU) and evaluate the outcomes. We performed a retrospective multi-center study in 16 French ICUs between 2008 and 2017. We compared the patients who survived in ICU and the patients who did not to identify factors associated with ICU survival. Then, we focused on the subgroup of patients with hematological malignancies. Results: Mucormycosis was diagnosed in 74 patients during the study period. Among them, 60 patients (81%) were immunocompromised: 41 had hematological malignancies, 9 were solid organ transplant recipients, 31 received long-term steroids, 11 had diabetes, 24 had malnutrition. Only 21 patients survived to ICU stay (28.4%) with a median survival of 22 days (Q1–Q3 = 9–106) and a survival rate at day 28 and day 90, respectively, of 35.1% and 26.4%. Survivors were significantly younger (p = 0.001), with less frequently hematological malignancies (p = 0.02), and less malnutrition (p = 0.05). Median survival in patients with hematological malignancies (n = 41) was 15 days (Q1–Q3 = 5–23.5 days). In this subgroup, curative surgery was a major factor associated with survival in multivariate analysis (odds ratio = 0.71, [0.45–0.97], p < 0.001). Conclusion: Overall prognosis of mucormycosis in ICU remains poor, especially in patients with hematological malignancies. In this subgroup of patients, a therapeutic strategy including curative surgery was the main factor associated with survival. [ABSTRACT FROM AUTHOR] |
|
Copyright of Annals of Intensive Care is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder