Epidemiology and outcome of fungemia in a cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031).

Details

Ressource 1Download: serval:BIB_46F4D73EE4C7.P001 (190.03 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_46F4D73EE4C7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Epidemiology and outcome of fungemia in a cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031).
Journal
Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America
Author(s)
Cornely O.A., Gachot B., Akan H., Bassetti M., Uzun O., Kibbler C., Marchetti O., de Burghgraeve P., Ramadan S., Pylkkanen L., Ameye L., Paesmans M., Donnelly J.P., Donnelly P.J.
Working group(s)
EORTC Infectious Diseases Group
Contributor(s)
Cornely OA., Gachot B., Akan H., Bassetti M., Uzun O., Kibbler CC., Marchetti O., Bille J., de Burghgraeve P., Pylkkanen L., Ameye L., Paesmans M., Donnelly PJ.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
61
Number
3
Pages
324-331
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Anti-cancer treatment and the cancer population have evolved since the last European Organisation for Research and Treatment of Cancer (EORTC) fungemia survey, and there are few recent large epidemiological studies.
METHODS: This was a prospective cohort study including 145 030 admissions of patients with cancer from 13 EORTC centers. Incidence, clinical characteristics, and outcome of fungemia were analyzed.
RESULTS: Fungemia occurred in 333 (0.23%; 95% confidence interval [CI], .21-.26) patients, ranging from 0.15% in patients with solid tumors to 1.55% in hematopoietic stem cell transplantation recipients. In 297 evaluable patients age ranged from 17 to 88 years (median 56 years), 144 (48%) patients were female, 165 (56%) had solid tumors, and 140 (47%) had hematological malignancies. Fungemia including polymicrobial infection was due to: Candida spp. in 267 (90%), C. albicans in 128 (48%), and other Candida spp. in 145 (54%) patients. Favorable overall response was achieved in 113 (46.5%) patients by week 2. After 4 weeks, the survival rate was 64% (95% CI, 59%-70%) and was not significantly different between Candida spp. Multivariable logistic regression identified baseline septic shock (odds ratio [OR] 3.04, 95% CI, 1.22-7.58) and tachypnoea as poor prognostic factors (OR 2.95, 95% CI, 1.66-5.24), while antifungal prophylaxis prior to fungemia (OR 0.20, 95% CI, .06-.62) and remission of underlying cancer (OR, 0.18; 95% CI, .06-.50) were protective.
CONCLUSIONS: Fungemia, mostly due to Candida spp., was rare in cancer patients from EORTC centers but was associated with substantial mortality. Antifungal prophylaxis and remission of cancer predicted better survival.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Antifungal Agents, Candida, Female, Fungemia/complications, Fungemia/epidemiology, Humans, Immunocompromised Host, Kaplan-Meier Estimate, Leukemia/complications, Leukemia/epidemiology, Male, Middle Aged, Prospective Studies, Shock, Septic, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
07/09/2015 15:42
Last modification date
25/09/2019 7:09
Usage data