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).

Détails

ID Serval
serval:BIB_46F4D73EE4C7
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
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).
Périodique
Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America
Auteur(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.
Collaborateur(s)
EORTC Infectious Diseases Group
Contributeur(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
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
61
Numéro
3
Pages
324-331
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
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.
Mots-clé
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
Oui
Création de la notice
07/09/2015 15:42
Dernière modification de la notice
08/05/2019 17:58
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