M. T. Montagna, G. Lovero, C. Coretti, D. Martinelli, M. Delia, O. D. Giglio, M. Caira, F. Puntillo, D. D'Antonio, M. Venditti, V. Sambri, F. D. Bernardo, A. Barbui, G. L. Cascio, E. Concia, M. Mikulska, C. Viscoli, N. Maximova, A. Candoni, S. Oliveri, G. 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
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.
