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1. Real-life use of ceftolozane/tazobactam for the treatment of bloodstream infection due to Pseudomonas aeruginosa in neutropenic hematologic patients: a matched control study (ZENITH study)

Author

Bergas, A. (Alba), Albasanz-Puig, A. (Adaia), Fernández-Cruz, A. (Ana), Machado, M. (Marina), Novo, A. (Andrés), Van-Duin, D. (David), Garcia-Vidal, C. (C.), Hakki, M. (Morgan), Ruiz-Camps, I. (Isabel), Pozo, J.L. (José Luis) del, Oltolini, C. (Chiara), DeVoe, C. (Catherine), Drgona, L. (Lubos), Gasch, O. (Oriol), Mikulska, M. (Malgorzata), Martín-Dávila, P. (Pilar), Peghin, M. (Maddalena), Laporte-Amargos, J. (J.), Durà-Miralles, X. (Xavier), Pallarès, N. (Natàlia), González-Barca, E. (Eva), Álvarez-Uría, A. (Ana), Puerta-Alcalde, P. (Pedro), Aguilar-Company, J. (Juan), Carmona-Torre, F. (Francisco de A.), Clerici, T.D. (Teresa Daniela), Doernberg, S.B. (Sarah B.), Petrikova, L. (Lucía), Capilla, S. (Silvia), Magnasco, L. (Laura), Fortún, J. (Jesús), Castaldo, N. (Nadia), Carratalà, J. (Jordi), and Gudiol, C. (Carlota)

Subjects
Hematologic malignancy, Tazobactam, Neutropenia, Epidemiology, Pseudomonas aeruginosa, Multidrug-resistant, Bacteremia, Gram-negative infections, Ceftolozane/Tazobactam, Therapy, Bloodstream infection, Malignancies
Abstract

We sought to assess the characteristics and outcomes of neutropenic hematologic patients with Pseudomonas aeruginosa (PA) bloodstream infection (BSI) treated with ceftolozane-tazobactam (C/T). We conducted a multicenter, international, matched-cohort study of PA BSI episodes in neutropenic hematologic patients who received C/T. Controls were patients with PA BSI treated with other antibiotics. Risk factors for overall 7-day and 30-day case fatality rates were analyzed. We compared 44 cases with 88 controls. Overall, 91% of episodes were caused by multidrug-resistant (MDR) strains. An endogenous source was the most frequent BSI origin (35.6%), followed by pneumonia (25.8%). There were no significant differences in patient characteristics between groups. C/T was given empirically in 11 patients and as definitive therapy in 41 patients. Treatment with C/T was associated with less need for mechanical ventilation (13.6% versus 33.3%; P = 0.021) and reduced 7-day (6.8% versus 34.1%; P = 0.001) and 30-day (22.7% versus 48.9%; P = 0.005) mortality. In the multivariate analysis, pneumonia, profound neutropenia, and persistent BSI were independent risk factors for 30-day mortality, whereas lower mortality was found among patients treated with C/T (adjusted OR [aOR] of 0.19; confidence interval [CI] 95% of 0.07 to 0.55; P = 0.002). Therapy with C/T was associated with less need for mechanical ventilation and reduced 7-day and 30-day case fatality rates compared to alternative agents in neutropenic hematologic patients with PA BSI. IMPORTANCE Ceftolozane-tazobactam (C/T) has been shown to be a safe and effective alternative for the treatment of difficult to treat infections due to Pseudomonas aeruginosa (PA) in the general nonimmunocompromised population. However, the experience of this agent in immunosuppressed neutropenic patients is very limited. Our study is unique because it is focused on extremely immunosuppressed hematological patients with neutropenia and bloodstream infection (BSI) due to PA (mainly multidrug resistant [MDR]), a scenario which is often associated with very high mortality rates. In our study, we found that the use of C/T for the treatment of MDR PA BSI in hematological neutropenic patients was significantly associated with improved outcomes, and, in addition, it was found to be an independent risk factor associated with increased survival. To date, this is the largest series involving neutropenic hematologic patients with PA BSI treated with C/T. Ceftolozane-tazobactam (C/T) has been shown to be a safe and effective alternative for the treatment of difficult to treat infections due to Pseudomonas aeruginosa (PA) in the general nonimmunocompromised population. However, the experience of this agent in immunosuppressed neutropenic patients is very limited.

Published
2022

2. Clinical predictive model of multidrug resistance in neutropenic cancer patients with bloodstream infection due to Pseudomonas aeruginosa

Author

Herrera, F., Cuervo, Guillermo, Carratalà, J., Novo, A., Manzur, A., Tilley, R., Yáñez, L., Del Pozo, J.L., Peghin, M., Araos, R., Hemmatti, P., Gomes, M.Z.R., Marin, J.I., Márquez-Gómez, I., Calik, S., Sipahi, O.R., Kanj, S.S., Montero, M., Maestro-De La Calle, G., Morales, I., Kern, W.V., Isler, B., García, E., Brunel, A.-S., Paz Morales, H., Drgona, L., Gasch, O., Tubau, Fe, Escrihuela-Vidal, Francesc, Martín-Dávila, P., Aguado, José María, Horcajada, Juan Pablo, Mikulska, M., Tebé, Cristian, Arias, Marisol Rodríguez, Aguilar-Company, Juan, Larrosa, Nieves, Cardozo, Celia, Garcia-Vidal, Carolina, Karim-Yaqub, Ibrahim, Greco, Raffaella, Montejo, M., AKOVA, MURAT, Oltolini, C., Abdala, E., Puerta-Alcalde, P., Ruiz-Camps, I., Mussetti, A., Pallarès, N., Laporte-Amargós, J., Albasanz-Puig, A., Gudiol, C., Cichero, Paola, Ayaz, Caglayan Merve, Céspedes, Roberto, López-Soria, Leire, Magnasco, Laura, Fortún, Jesús, Torres, Diego, Boté, Anna, Espasa, Mateu, Montaguti, Mia Hold, Bochud, Pierre-Yves, Manuel, Oriol, Carrasco, Salvador Tabares, López, Josefina Serrano, Bertz, Hartmut, Rieg, Siegbert, De Cueto, Marina, Rodríguez-Baño, Jesús, Lizasoain, Manuel, Sangro Del Alcázar, Paloma, Castaldo, Nadia, Bassetti, Matteo, Munita, Jose, Maschmeyer, Georg, Tonhá, João Pedro Silva, Aparecida Da Silva Machado, Amanda, Correa, Lina Clemencia, Palop, Begoña, Nazli-Zeka, Arzu, Uyan-Onal, Ayse, Jabbour, Jean-Francois, El Zein, Saeed, Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), Red Española de Investigación en Patología Infecciosa, European Commission, Promex Stiftung Fur Die Forschung, Gilead Sciences, MSD, Astellas Pharma, Novartis, Pfizer, and Ege Üniversitesi

Subjects
Male, Carbapenem, Bacteremia, predictive model, 0302 clinical medicine, Risk Factors, Drug Resistance, Multiple, Bacterial, Neoplasms, Pharmacology (medical), 030212 general & internal medicine, Antibiotic prophylaxis, Cancer, 0303 health sciences, Middle Aged, Antibiotic coverage, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Pseudomonas aeruginosa, Female, medicine.drug, medicine.medical_specialty, Neutropenia, Antibiotic sensitivity, bloodstream infection, Microbial Sensitivity Tests, Tazobactam, Models, Biological, Epidemiology and Surveillance, 03 medical and health sciences, Internal medicine, medicine, cancer, Humans, Pseudomonas Infections, multidrug resistant, Pseudomonas aeruginosa, bacteremia, bloodstream infection, neutropenia, cancer, risk factors, predictive model, Retrospective Studies, Pharmacology, 030306 microbiology, business.industry, multidrug resistant, Retrospective cohort study, Odds ratio, Multidrug resistant, Risk factors, ROC Curve, Predictive model, Bloodstream infections, business, Bloodstream infection, Piperacillin
Abstract

We aimed to assess the rate and predictive factors of bloodstream infection (BSI) due to multidrug-resistant (MDR) Pseudomonas aeruginosa in neutropenic cancer patients. We performed a multicenter, retrospective cohort study including oncohematological neutropenic patients with BSI due to P. aeruginosa conducted across 34 centers in 12 countries from January 2006 to May 2018. A mixed logistic regression model was used to estimate a model to predict the multidrug resistance of the causative pathogens. of a total of 1,217 episodes of BSI due to P. aeruginosa, 309 episodes (25.4%) were caused by MDR strains. the rate of multidrug resistance increased significantly over the study period (P = 0.033). Predictors of MDR P. aeruginosa BSI were prior therapy with piperacillin-tazobactam (odds ratio [OR), 3.48; 95% confidence interval [CI], 2.29 to 5.30), prior antipseudomonal carbapenem use (OR, 2.53; 95% CI, 1.65 to 3.87), fluoroquinolone prophylaxis (OR, 2.99; 95% CI, 1.92 to 4.64), underlying hematological disease (OR, 2.09; 95% CI, 1.26 to 3.44), and the presence of a urinary catheter (OR, 2.54; 95% CI, 1.65 to 3.91), whereas older age (OR, 0.98; 95% CI, 0.97 to 0.99) was found to be protective. Our prediction model achieves good discrimination and calibration, thereby identifying neutropenic patients at higher risk of BSI due to MDR P. aeruginosa. the application of this model using a web-based calculator may be a simple strategy to identify high-risk patients who may benefit from the early administration of broad-spectrum antibiotic coverage against MDR strains according to the local susceptibility patterns, thus avoiding the use of broad-spectrum antibiotics in patients at a low risk of resistance development., ESGBIES study group; ESGICH study group; Spanish Plan Nacional de I+D+i 2013-2016; Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Economia, Industria y Competitividad, Spanish Network for Research in Infectious Diseases [REIPI RD16/0016/0001]; European Development Regional Fund A Way To Achieve Europe, Operative Program Intelligent Growth 2014-2020; Promex Stiftung fur die Forschung (Carigest SA); GileadGilead Sciences; PfizerPfizer, We thank the ESGBIES and the ESGICH study groups for supporting the study.; This study was supported by the Spanish Plan Nacional de I+D+i 2013-2016 and the Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Economia, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (grant REIPI RD16/0016/0001), cofinanced by the European Development Regional Fund A Way To Achieve Europe, Operative Program Intelligent Growth 2014-2020.; A.-S.B. received a grant from Promex Stiftung fur die Forschung (via Carigest SA) and funding from Gilead to attend the ECCMID Congress (2018). O.R.S. received speaker honoraria from MSD, Astellas, Novartis, and Pfizer. S.S.K. received speaker honoraria from Pfizer, MSD, Astellas. F.H. received speaker honoraria from MSD, and Pfizer and a research and educational grant from Pfizer. the rest of the authors declare no conflicts of interest.

Published
2020

3. Impact of antibiotic resistance on outcomes of neutropenic cancer patients with Pseudomonas aeruginosa bacteraemia (IRONIC study): study protocol of a retrospective multicentre international study

Author

Albasanz-Puig, A. (Adaia), Gudiol, C. (Carlota), Parody, R. (Rocío), Tebe, C. (C.), Akova, M. (Murat), Araos, R. (Rafael), Brunel, A.S. (Anne Sophie), Calik, S. (Sebnem), Drgona, L. (Lubos), García, E. (Estefania), Hemmati, P. (Philipp), Herrera, F. (Fabián), Ibrahim, K. (Karim), Isler, B. (Burcu), Kanj, S. (Souha), Kern, W. (Winfried), Maestro-de-la-Calle, G. (Guillermo), Manzur, A. (Adriana), Marin, J.I. (Jorge Iván), Márquez-Gómez, I. (Ignacio), Martín-Dávila, P. (Pilar), Mikulska, M. (Malgorzata), Montejo, J.M. (José Miguel), Montero, M. (Milagros), Paz-Morales, H.M. (Hugo Manuel), Morales, I. (Isabel), Novo, A. (Andrés), Oltolini, C. (Chiara), Peghin, M. (Maddalena), Pozo, J.L. (José Luis) del, Puerta-Alcalde, P. (Pedro), Ruiz-Camps, I. (Isabel), Sipahi, O. (Oguz), Tilley, R. (Robert), Yáñez, L. (Lucrecia), Ribeiro, M. (Marisa), and Carratalà, J. (Jordi)

Subjects
Pseudomonas aeruginosa (PA), Onco-haematological patients, Multidrug-resistant
Abstract

Introduction: Pseudomonas aeruginosa (PA) has historically been one of the major causes of severe sepsis and death among neutropenic cancer patients. There has been a recent increase of multidrug-resistant PA (MDRPA) isolates that may determine a worse prognosis, particularly in immunosuppressed patients. The aim of this study is to establish the impact of antibiotic resistance on the outcome of neutropenic onco-haematological patients with PA bacteraemia, and to identify the risk factors for MDRPA bacteraemia and mortality. Methods and analysis: This is a retrospective, observational, multicentre, international study. All episodes of PA bacteraemia occurring in neutropenic oncohaematological patients followed up at the participating centres from 1 January 2006 to 31 May 2018 will be retrospectively reviewed. The primary end point will be overall case-fatality rate within 30 days of onset of PA bacteraemia. The secondary end points will be to describe the following: the incidence and risk factors for multidrugresistant and extremely drug-resistant PA bacteraemia (by comparing the episodes due to susceptible PA with those produced by MDRPA), the efficacy of ceftolozane/ tazobactam, the rates of persistent bacteraemia and bacteraemia relapse and the risk factors for very early (48 hours), early (7 days) and overall (30 days) case-fatality rates. Ethics and dissemination: The Clinical Research Ethics Committee of Bellvitge University Hospital approved the protocol of the study at the primary site. To protect personal privacy, identifying information of each patient in the electronic database will be encrypted. The processing of the patients’ personal data collected in the study will comply with the Spanish Data Protection Act of 1998 and with the European Directive on the privacy of data. All data collected, stored and processed will be anonymised. Results will be reported at conferences and in peerreviewed publications.

Published
2019

4. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium

Author

Cornely, O.A. Alastruey-Izquierdo, A. Arenz, D. Chen, S.C.A. Dannaoui, E. Hochhegger, B. Hoenigl, M. Jensen, H.E. Lagrou, K. Lewis, R.E. Mellinghoff, S.C. Mer, M. Pana, Z.D. Seidel, D. Sheppard, D.C. Wahba, R. Akova, M. Alanio, A. Al-Hatmi, A.M.S. Arikan-Akdagli, S. Badali, H. Ben-Ami, R. Bonifaz, A. Bretagne, S. Castagnola, E. Chayakulkeeree, M. Colombo, A.L. Corzo-León, D.E. Drgona, L. Groll, A.H. Guinea, J. Heussel, C.-P. Ibrahim, A.S. Kanj, S.S. Klimko, N. Lackner, M. Lamoth, F. Lanternier, F. Lass-Floerl, C. Lee, D.-G. Lehrnbecher, T. Lmimouni, B.E. Mares, M. Maschmeyer, G. Meis, J.F. Meletiadis, J. Morrissey, C.O. Nucci, M. Oladele, R. Pagano, L. Pasqualotto, A. Patel, A. Racil, Z. Richardson, M. Roilides, E. Ruhnke, M. Seyedmousavi, S. Sidharthan, N. Singh, N. Sinko, J. Skiada, A. Slavin, M. Soman, R. Spellberg, B. Steinbach, W. Tan, B.H. Ullmann, A.J. Vehreschild, J.J. Vehreschild, M.J.G.T. Walsh, T.J. White, P.L. Wiederhold, N.P. Zaoutis, T. Chakrabarti, A. Mucormycosis ECMM MSG Global Guideline Writing Group

Abstract

Mucormycosis is a difficult to diagnose rare disease with high morbidity and mortality. Diagnosis is often delayed, and disease tends to progress rapidly. Urgent surgical and medical intervention is lifesaving. Guidance on the complex multidisciplinary management has potential to improve prognosis, but approaches differ between health-care settings. From January, 2018, authors from 33 countries in all United Nations regions analysed the published evidence on mucormycosis management and provided consensus recommendations addressing differences between the regions of the world as part of the “One World One Guideline” initiative of the European Confederation of Medical Mycology (ECMM). Diagnostic management does not differ greatly between world regions. Upon suspicion of mucormycosis appropriate imaging is strongly recommended to document extent of disease and is followed by strongly recommended surgical intervention. First-line treatment with high-dose liposomal amphotericin B is strongly recommended, while intravenous isavuconazole and intravenous or delayed release tablet posaconazole are recommended with moderate strength. Both triazoles are strongly recommended salvage treatments. Amphotericin B deoxycholate is recommended against, because of substantial toxicity, but may be the only option in resource limited settings. Management of mucormycosis depends on recognising disease patterns and on early diagnosis. Limited availability of contemporary treatments burdens patients in low and middle income settings. Areas of uncertainty were identified and future research directions specified. © 2019 Elsevier Ltd

Published
2019

5. Guidelines for the management of cytomegalovirus infection in patients with haematological malignancies and after stem cell transplantation from the 2017 European Conference on Infections in Leukaemia (ECIL 7)

Author

Greinix H, Slavin M, De Greef J, Maertens J, Hubacek P, Racil Z, Lundgren J, Bergeron A, Cordonnier C, Di Blasi R, Herbrecht R, Lortholary O, Robin C, Thiebaut A, Einsele H, Lehrnbecher T, Maschmeyer G, Mellinghoff S, Penack O, Roilides E, Kassa C, Averbuch D, Busca A, Cesaro S, Crocchiolo R, Gallo G, Mikulska M, Nosari A, Pagano L, Viscoli C, Blijlevens N, Donnelly P, Koltan P, Styczynski J, de Sousa A, Klyasova G, Aljurf M, Drgona L, de la Camara R, Duarte R, Martino R, Navarro D, Rovira M, Einarsdottir S, Ljungman P, Paukssen K, Wenneras C, Calandra T, Akova M, de Lavallade H, Ward K, Hill J, Dubel L, Mills L, Rupp M, Sanchez S, Zeitler S, and 2017 European Conf Infect Leuka

Published
2019

6. ECIL guidelines for treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients

Author

Maschmeyer, G., Helweg-Larsen, J., Pagano, L., Robin, C., Cordonnier, C., Akova M, Schellongowski P., Aljurf, M, Averbuch, D, Barnes, R, Blennow, O, Bochud, Py, Bouza, E, Bretagne, S, Brüggemann, R, Calandra, T, Carratalà, J, Cesaro, S, Cordonnier, C, Cornely, O, Dalianis, T, de la Camara, R, Donnelly, P, Drgona, L, Duarte, R, Einsele, H, Engelhard, D, Fox, C, Girmenia, C, Groll, A, Heldal, D, Helweg-Larsen, J, Herbrecht, R, Hirsch, H, Johnson, E, Klyasova, G, Koskuenvo, M, Lagrou, K, Lewis, Re, Ljungman, P, Maertens, J, Maschmeyer, G, Mikulska, M, Nucci, M, Padoin, C, Pagano, L, Pagliuca, A, Racil, Z, Ribaud, P, Rinaldo, C, Rizzi-Puechal, V, Roilides, E, Robin, C, Rovira, M, Rupp, M, Sanchez, S, Schellongowski, P, Sedlacek, P, Sinko, J, Slavin, M, Ferreira, Is, Styczynski, J, Tissot, F, Viscoli, C, Ward, K, and Witschi, At.

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Primaquine, Antifungal Agents, medicine.medical_treatment, 030106 microbiology, Pneumocystis carinii, Trimethoprim, 03 medical and health sciences, Internal medicine, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, Humans, Pharmacology (medical), immunocompromised host, Pharmacology, Mechanical ventilation, Sulfamethoxazole Drug Combination, medicine.diagnostic_test, Pneumocystis, business.industry, Clindamycin, Pneumonia, Pneumocystis, Pneumonia, medicine.disease, Pnoumocistis jirovecii therapy, Surgery, Settore MED/15 - MALATTIE DEL SANGUE, Regimen, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Infectious Diseases, Bronchoalveolar lavage, Administration, Intravenous, Hematologic Neoplasms, Respiratory failure, Administration, Intravenous, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5], immunocompromised host, Pnoumocistis jirovecii therapy, medicine.drug
Abstract

The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay the start of treatment. Most patients with haematological malignancies present with a severe PCP; therefore, antimicrobial therapy should be started intravenously. High-dose trimethoprim/sulfamethoxazole is the treatment of choice. In patients with documented intolerance to this regimen, the preferred alternative is the combination of primaquine plus clindamycin. Treatment success should be first evaluated after 1 week, and in case of clinical non-response, pulmonary CT scan and bronchoalveolar lavage should be repeated to look for secondary or co-infections. Treatment duration typically is 3 weeks and secondary anti-PCP prophylaxis is indicated in all patients thereafter. In patients with critical respiratory failure, non-invasive ventilation is not significantly superior to intubation and mechanical ventilation. The administration of glucocorticoids must be decided on a case-by-case basis.

Published
2016

7. COMPARISON OF GALACTOMANNAN DETECTED IN SERUM/BRONCHOALVEOLAR LAVAGE FLUID AND TYPE OF ABNORMALITY ON PULMONARY HIGH RESOLUTION COMPUTER TOMOGRAPHY IN PATIENTS WITH PULMONARY INVASIVE ASPERGILLOSIS

Author

Weinbergerova, B., Racil, Z., Maluskova, D., Muzik, J., Kocmanova, I., Drgona, L., Kouba, M., Hricinova, M., Guman, T., Gabzdilova, J., Haber, J., Kristina Forsterova, Bojtarova, E., Ziakova, B., Novak, J., Chrenkova, V., Sedlacek, P., Vokurka, S., Mudry, P., Tkacikova, B., Zavrelova, A., Zak, P., Ostojic, A., Vrhovac, R., Sejnova, D., Zatezalo, V., Gredelj, N., Mallatova, N., Timr, P., Horakova, J., Chocholova, A., Navratil, M., Hajek, R., Rolencova, M., Mayer, J., Cetkovsky, P., Dusek, L., and Cools, Jan

Subjects
carbohydrates (lipids), respiratory system, Invasive aspergillosis, Galactomannan, HRCT, bacterial infections and mycoses, skin and connective tissue diseases, respiratory tract diseases
Abstract

Background: Up to now there have been missing data in the literature concerning relationship of galactomannan (GM) detected in bronchoalveolar lavage (BAL) fluid and type of abnormality on pulmonary high resolution computer tomography (HRCT) in patients (pts.) with pulmonary invasive aspergillosis (IPA). Aims: To evaluate relationship between sensitivity of GM detected in BAL fluid and serum (S-GM) and type of abnormality on pulmonary HRCT in pts. with IPA. Methods: We retrospectively analyzed mentioned relationship in pts. with IPA entered in „Fungal InfectioN Database (FIND)“ aspergillus between 2001 and 2012.

Published
2014

8. Invasive aspergillosis in patients with hematological malignancies in Czech and Slovak Republics: fungal infection database (find) analysis (2001-2011) - an update

Author

Weinbergerova, B., Racil, Z., Kocmanova, I., Muzik, J., Kouba, M., Vydra, J., Drgona, L., Masarova, L., Gabzdilova, J., Guman, T., Ziakova, B., Bojtarova, E., Forsterova, K., Haber, J., Chrenkova, V., Sedlacek, P., Novak, J., Heklova, R., Mudry, P., Sejnova, D., SAMUEL VOKURKA, Karas, M., Mallatova, N., Chocholova, A., Horakova, J., Ligova, A., Ostojic, A., Vrhovac, R., Timr, P., Gredelj, N., Rolencova, M., Kandrnal, V., Cetkovsky, P., Mayer, J., Cornely, O. A., Meis, J. F. G. M., and Schaller, M.

Subjects
Invasive aspergillosis, Hematologic malignancies
Abstract

Objectives: “Fungal InfectioN Database” (FIND) represents international database of invasive fungal infections in Czech and Slovak hematooncological departments. FIND - aspergillus covers all case of invasive aspergillosis (IA) in participating centers since 2001. Methods: The goal of our retrospective analysis was to evaluate incidence, early diagnostic procedures and effect of antifungal therapy in proven and probable IA that occurred in 16 institutions participating in FIND database between 2001–2011. Till 2009 we followed EORTC/MSG 2002 and from 2010 EORTC/MSG 2008 criteria in evaluation of IA diagnosis and therapy response. Results: 256 probable and 58 proven IA (91% isolated pulmonary IA, IPA) have been documented. Prolonged and profound neutropenia (61%) and long-term use of corticosteroids (28%) were identified as the major risk factors of IA. 68% pts. had consecutive positivity of serum-galactomannan (S-GM) (OD index >0.5). 83% pts. with IPA and bronchoalveolar lavage (BAL) had positive GM in BAL fluid (OD index >0.5). In pts. with IPA only 7.6% BAL fluids and 8.4% sputum samples had positive microscopic result for filamentous fungi and 2.2% BAL fluids and 1.8% sputum samples had positive culture for Aspergillus spp. The primary antifungal therapy of IA was used in 89% pts. - 41% voriconazole (VORI), 7% echinocandins (ECHINO), 23% VORI+ECHINO, 7% amphotericine B deoxycholate (C-AMB) and 9% lipid- based AMB (LBA). Overall RR to primary therapy of IA was 46% - VORI 55%, VORI+ECHINO 54%, C-AMB 35%, LBA 39%, ECHINO 25%. There was a statistically significant difference in overall RR to targeted therapy in pts. with neutrophil count 1.0x10e9/L at the end of therapy (21% vs. 71%). The overall mortality rate was 61%, with 39% attributable to IA. Conclusion: On the basis of our analysis we confirm typical risk factors for IA and critical role of S-GM and CT for early diagnosis and prompt start of antifungal therapy of IA. A reasonable treatment response was achieved using VORI, VORI+ECHINO or LBA in primary therapy of IA. We have confirmed neutropenia at the end of antifungal therapy as the major predictive factor for therapeutic response. On behalf of CELL - The Czech leukemia study group for life.

10. Invasive aspergillosis in patients with hematological malignancies in Czech, Slovak and Croatian hematooncological departments: Fungal INfection Database (FIND) analysis (2001-2014) - an update

Author

Weinbergerova, B., Racil, Z., Kocmanova, I., Lengerova, M., Janousova, E., Drgona, L., Kouba, M., Hricinova, M., Ostojic, A., Vrhovac, R., Gabzdilova, J., Guman, T., Petecukova, V., Novak, J., Forsterova, K., Haber, J., Ziakova, B., Bojtarova, E., Zavrelova, A., Vokurka, S., Chrenkova, V., Sedlacek, P., Tkacikova, B., Mudry, P., Zatezalo, V., Gredelj, N., Mallatova, N., Timr, P., Sejnova, D., Tanuskova, D., Chocholova, A., Horakova, J., Navratil, M., Roman Hajek, Chudej, J., Sokol, J., Rolencova, M., Zak, P., Cetkovsky, P., and Mayer, J.

Subjects
invasive aspergillosis, education, population characteristics, health care economics and organizations, geographic locations, humanities
Abstract

Invasive aspergillosis in patients with hematological malignancies in Czech, Slovak and Croatian hematooncological departments: Fungal INfection Database (FIND) analysis (2001-2014) - an update

12. COVID-19 infection in adult patients with hematological malignancies:a European Hematology Association Survey (EPICOVIDEHA)

Author

Pagano, Livio, Salmanton-García, Jon, Marchesi, Francesco, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Verga, Luisa, Víšek, Benjamin, Ilhan, Osman, Nadali, Gianpaolo, Weinbergerová, Barbora, Córdoba-Mascuñano, Raúl, Marchetti, Monia, Collins, Graham P., Farina, Francesca, Cattaneo, Chiara, Cabirta, Alba, Gomes-Silva, Maria, Itri, Federico, van Doesum, Jaap, Ledoux, Marie-Pierre, Čerňan, Martin, Jakšić, Ozren, Duarte, Rafael F., Magliano, Gabriele, Omrani, Ali S., Fracchiolla, Nicola S., Kulasekararaj, Austin, Valković, Toni, Poulsen, Christian Bjørn, Machado, Marina, Glenthøj, Andreas, Stoma, Igor, Ráčil, Zdeněk, Piukovics, Klára, Navrátil, Milan, Emarah, Ziad, Sili, Uluhan, Maertens, Johan, Blennow, Ola, Bergantim, Rui, García-Vidal, Carolina, Prezioso, Lucia, Guidetti, Anna, del Principe, Maria Ilaria, Popova, Marina, de Jonge, Nick, Ormazabal-Vélez, Irati, Fernández, Noemí, Falces-Romero, Iker, Cuccaro, Annarosa, Meers, Stef, Buquicchio, Caterina, Antić, Darko, Al-Khabori, Murtadha, García-Sanz, Ramón, Biernat, Monika M., Tisi, Maria Chiara, Sal, Ertan, Rahimli, Laman, Čolović, Natasa, Schönlein, Martin, Calbacho, Maria, Tascini, Carlo, Miranda-Castillo, Carolina, Khanna, Nina, Méndez, Gustavo-Adolfo, Petzer, Verena, Novák, Jan, Besson, Caroline, Duléry, Rémy, Lamure, Sylvain, Nucci, Marcio, Zambrotta, Giovanni, Žák, Pavel, Seval, Guldane Cengiz, Bonuomo, Valentina, Mayer, Jiří, López-García, Alberto, Sacchi, Maria Vittoria, Booth, Stephen, Ciceri, Fabio, Oberti, Margherita, Salvini, Marco, Izuzquiza, Macarena, Nunes-Rodrigues, Raquel, Ammatuna, Emanuele, Obr, Aleš, Herbrecht, Raoul, Núñez-Martín-Buitrago, Lucía, Mancini, Valentina, Shwaylia, Hawraa, Sciumè, Mariarita, Essame, Jenna, Nygaard, Marietta, Batinić, Josip, Gonzaga, Yung, Regalado-Artamendi, Isabel, Karlsson, Linda Katharina, Shapetska, Maryia, Hanakova, Michaela, El-Ashwah, Shaimaa, Borbényi, Zita, Çolak, Gökçe Melis, Nordlander, Anna, Dragonetti, Giulia, Maraglino, Alessio Maria Edoardo, Rinaldi, Amelia, De Ramón-Sánchez, Cristina, Cornely, Oliver A., Finizio, Olimpia, Fazzi, Rita, Sapienza, Giuseppe, Chauchet, Adrien, Van Praet, Jens, Prattes, Juergen, Dargenio, Michelina, Rossi, Cédric, Shirinova, Ayten, Malak, Sandra, Tafuri, Agostino, Ommen, Hans-Beier, Bologna, Serge, Khedr, Reham Abdelaziz, Choquet, Sylvain, Joly, Bertrand, Ceesay, M. Mansour, Philippe, Laure, Kho, Chi Shan, Desole, Maximilian, Tsirigotis, Panagiotis, Otašević, Vladimir, Borducchi, Davimar M. M., Antoniadou, Anastasia, Gaziev, Javid, Almaslamani, Muna A., García-Poutón, Nicole, Paterno, Giovangiacinto, Torres-López, Andrea, Tarantini, Giuseppe, Mellinghoff, Sibylle, Gräfe, Stefanie, Börschel, Niklas, Passweg, Jakob, Merelli, Maria, Barać, Aleksandra, Wolf, Dominik, Shaikh, Mohammad Usman, Thiéblemont, Catherine, Bernard, Sophie, Funke, Vaneuza Araújo Moreira, Daguindau, Etienne, Khostelidi, Sofya, Nucci, Fabio Moore, Martín-González, Juan-Alberto, Landau, Marianne, Soussain, Carole, Laureana, Cécile, Lacombe, Karine, Kohn, Milena, Aliyeva, Gunay, Piedimonte, Monica, Fouquet, Guillemette, Rêgo, Mayara, Hoell-Neugebauer, Baerbel, Cartron, Guillaume, Pinto, Fernando, Alburquerque, Ana Munhoz, Passos, Juliana, Yilmaz, Asu Fergun, Redondo-Izal, Ana-Margarita, Altuntaş, Fevzi, Heath, Christopher, Kolditz, Martin, Schalk, Enrico, Guolo, Fabio, Karthaus, Meinolf, Della Pepa, Roberta, Vinh, Donald, Noël, Nicolas, Deau Fischer, Bénédicte, Drenou, Bernard, Mitra, Maria Enza, Meletiadis, Joseph, Bilgin, Yavuz M., Jindra, Pavel, Espigado, Ildefonso, Drgoňa, Ľuboš, Serris, Alexandra, Di Blasi, Roberta, Ali, Natasha, EPICOVIDEHA working group, [missing], Pagano, Livio, Salmanton-Garcia, Jon, Marchesi, Francesco, Busca, Alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Verga, Luisa, Visek, Benjamin, Ilhan, Osman, Nadali, Gianpaolo, Weinbergerova, Barbora, Cordoba-Mascunano, Raul, Marchetti, Monia, Collins, Graham P., Farina, Francesca, Cattaneo, Chiara, Cabirta, Alba, Gomes-Silva, Maria, Itri, Federico, van Doesum, Jaap, Ledoux, Marie-Pierre, Cernan, Martin, Jaksic, Ozren, Duarte, Rafael F., Magliano, Gabriele, Omrani, Ali S., Fracchiolla, Nicola S., Kulasekararaj, Austin, Valkovic, Toni, Poulsen, Christian Bjorn, Machado, Marina, Glenthoj, Andreas, Stoma, Igor, Racil, Zdenek, Piukovics, Klara, Navratil, Milan, Emarah, Ziad, Sili, Uluhan, Maertens, Johan, Blennow, Ola, Bergantim, Rui, Garcia-Vidal, Carolina, Prezioso, Lucia, Guidetti, Anna, del Principe, Maria Ilaria, Popova, Marina, de Jonge, Nick, Ormazabal-Velez, Irati, Fernandez, Noemi, Falces-Romero, Iker, Cuccaro, Annarosa, Meers, Stef, Buquicchio, Caterina, Antic, Darko, Al-Khabori, Murtadha, Garcia-Sanz, Ramon, Biernat, Monika M., Tisi, Maria Chiara, Sal, Ertan, Rahimli, Laman, Colovic, Natasa, Schonlein, Martin, Calbacho, Maria, Tascini, Carlo, Miranda-Castillo, Carolina, Khanna, Nina, Mendez, Gustavo-Adolfo, Petzer, Verena, Novak, Jan, Besson, Caroline, Dulery, Remy, Lamure, Sylvain, Nucci, Marcio, Zambrotta, Giovanni, Zak, Pavel, Seval, Guldane Cengiz, Bonuomo, Valentina, Mayer, Jiri, Lopez-Garcia, Alberto, Sacchi, Maria Vittoria, Booth, Stephen, Ciceri, Fabio, Oberti, Margherita, Salvini, Marco, Izuzquiza, Macarena, Nunes-Rodrigues, Raquel, Ammatuna, Emanuele, Obr, Ales, Herbrecht, Raoul, Nunez-Martin-Buitrago, Lucia, Mancini, Valentina, Shwaylia, Hawraa, Sciume, Mariarita, Essame, Jenna, Nygaard, Marietta, Batinic, Josip, Gonzaga, Yung, Regalado-Artamendi, Isabel, Karlsson, Linda Katharina, Shapetska, Maryia, Hanakova, Michaela, El-Ashwah, Shaimaa, Borbenyi, Zita, Colak, Gokce Melis, Nordlander, Anna, Dragonetti, Giulia, Maraglino, Alessio Maria Edoardo, Rinaldi, Amelia, De Ramon-Sanchez, Cristina, Cornely, Oliver A., Pagano, L., Salmanton-Garcia, J., Marchesi, F., Busca, A., Corradini, P., Hoenigl, M., Klimko, N., Koehler, P., Pagliuca, A., Passamonti, F., Verga, L., Visek, B., Ilhan, O., Nadali, G., Weinbergerova, B., Cordoba-Mascunano, R., Marchetti, M., Collins, G. P., Farina, F., Cattaneo, C., Cabirta, A., Gomes-Silva, M., Itri, F., van Doesum, J., Ledoux, M. -P., Cernan, M., Jaksic, O., Duarte, R. F., Magliano, G., Omrani, A. S., Fracchiolla, N. S., Kulasekararaj, A., Valkovic, T., Poulsen, C. B., Machado, M., Glenthoj, A., Stoma, I., Racil, Z., Piukovics, K., Navratil, M., Emarah, Z., Sili, U., Maertens, J., Blennow, O., Bergantim, R., Garcia-Vidal, C., Prezioso, L., Guidetti, A., del Principe, M. I., Popova, M., de Jonge, N., Ormazabal-Velez, I., Fernandez, N., Falces-Romero, I., Cuccaro, A., Meers, S., Buquicchio, C., Antic, D., Al-Khabori, M., Garcia-Sanz, R., Biernat, M. M., Tisi, M. C., Sal, E., Rahimli, L., Colovic, N., Schonlein, M., Calbacho, M., Tascini, C., Miranda-Castillo, C., Khanna, N., Mendez, G. -A., Petzer, V., Novak, J., Besson, C., Dulery, R., Lamure, S., Nucci, M., Zambrotta, G., Zak, P., Seval, G. C., Bonuomo, V., Mayer, J., Lopez-Garcia, A., Sacchi, M. V., Booth, S., Ciceri, F., Oberti, M., Salvini, M., Izuzquiza, M., Nunes-Rodrigues, R., Ammatuna, E., Obr, A., Herbrecht, R., Nunez-Martin-Buitrago, L., Mancini, V., Shwaylia, H., Sciume, M., Essame, J., Nygaard, M., Batinic, J., Gonzaga, Y., Regalado-Artamendi, I., Karlsson, L. K., Shapetska, M., Hanakova, M., El-Ashwah, S., Borbenyi, Z., Colak, G. M., Nordlander, A., Dragonetti, G., Maraglino, A. M. E., Rinaldi, A., De Ramon-Sanchez, C., Cornely, O. A., Finizio, O., Fazzi, R., Sapienza, G., Chauchet, A., Van Praet, J., Prattes, J., Dargenio, M., Rossi, C., Shirinova, A., Malak, S., Tafuri, A., Ommen, H. -B., Bologna, S., Khedr, R. A., Choquet, S., Joly, B., Ceesay, M. M., Philippe, L., Kho, C. S., Desole, M., Tsirigotis, P., Otasevic, V., Borducchi, D. M. M., Antoniadou, A., Gaziev, J., Almaslamani, M. A., Garcia-Pouton, N., Paterno, G., Torres-Lopez, A., Tarantini, G., Mellinghoff, S., Grafe, S., Borschel, N., Passweg, J., Merelli, M., Barac, A., Wolf, D., Shaikh, M. U., Thieblemont, C., Bernard, S., Funke, V. A. M., Daguindau, E., Khostelidi, S., Nucci, F. M., Martin-Gonzalez, J. -A., Landau, M., Soussain, C., Laureana, C., Lacombe, K., Kohn, M., Aliyeva, G., Piedimonte, M., Fouquet, G., Rego, M., Hoell-Neugebauer, B., Cartron, G., Pinto, F., Alburquerque, A. M., Passos, J., Yilmaz, A. F., Redondo-Izal, A. -M., Altuntas, F., Heath, C., Kolditz, M., Schalk, E., Guolo, F., Karthaus, M., Della Pepa, R., Vinh, D., Noel, N., Deau Fischer, B., Drenou, B., Mitra, M. E., Meletiadis, J., Bilgin, Y. M., Jindra, P., Espigado, I., Drgona, L., Serris, A., Di Blasi, R., Ali, N., Stem Cell Aging Leukemia and Lymphoma (SALL), Salvy-Córdoba, Nathalie, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), University Hospital of Cologne [Cologne], Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, IFO - Istituto Nazionale Tumori Regina Elena [Roma] (IRE), Città della Salute e della Scienza University-Hospital, IRCCS Istituto Nazionale dei Tumori [Milano], University of California [San Diego] (UC San Diego), University of California (UC), Medical University of Graz, Odessa National I.I.Mechnikov University, Faculty of Medicine [Cologne], University Hospital of Cologne [Cologne]-University of Cologne, King's College Hospital (KCH), Universitá degli Studi dell’Insubria = University of Insubria [Varese] (Uninsubria), Dipartimento di Medicina e Chirurgia = School of Medicine and Surgery [Monza], Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Faculty of Medicine in Hradec Kralove [Republique Tchèque], Charles University [Prague] (CU), Ankara University School of Medicine [Turkey], Azienda Ospedaliera Universitaria Integrata of Verona, Masaryk University [Brno] (MUNI), Fundación Jiménez Díaz, Fundacion Jimenez Diaz [Madrid] (FJD), Ospedale SS Antonio e Biagio e Cesare Arrigo, Churchill Hospital Oxford Centre for Haematology, IRCCS San Raffaele Scientific Institute [Milan, Italie], ASST Spedali Civili of Brescia, Vall d'Hebron Institute of Oncology [Barcelone] (VHIO), Vall d'Hebron University Hospital [Barcelona], Universitat Autònoma de Barcelona (UAB), Instituto Português de Oncologia de Lisboa Francisco Gentil, Ospedale San Luigi Gonzaga, University Medical Center Groningen [Groningen] (UMCG), Institut de Cancérologie de Strasbourg Europe (ICANS), Palacky University Olomouc, Zagreb School of Medicine [Zagreb, Croatia] (Dubrava University Hospital), University of Zagreb, Hospital Universitario Puerta de Hierro-Majadahonda [Madrid, Spain], ASST Great Metropolitan Niguarda / ASST Grande Ospedale Metropolitano Niguarda [Milan, Italia], Hamad Medical Corporation [Doha, Qatar], Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Rijeka, Croatian Cooperative Group for Hematological Diseases (CROHEM), Zealand University Hospital [Roskilde, Denmark], Hospital General Universitario 'Gregorio Marañón' [Madrid], Department of Clinical Microbiology [Rigshospitalet], Rigshospitalet [Copenhagen], Copenhagen University Hospital-Copenhagen University Hospital, Homieĺ State Medical University (GSMU), Institute of Hematology and Blood Transfusion [Prague, Czech Republic], University of Szeged [Szeged], University Hospital Ostrava, Mansoura University [Egypt], Marmara University [Kadıköy - İstanbul], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Karolinska University Hospital [Stockholm], Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto = University of Porto, Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Hospital de São João [Porto], Faculdade de Medicina da Universidade do Porto (FMUP), Clinic Barcelona Hospital Universitari, Department of Public Health and Cell Biology, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy, Pavlov First Saint Petersburg State Medical University [St. Petersburg], Vrije Universiteit Medical Centre (VUMC), Vrije Universiteit Amsterdam [Amsterdam] (VU), Complejo Hospitalario de Navarra, Hospital Universitario Marqués de Valdecilla [Santander], La Paz University Hospital, Azienda Usl Toscana centro [Firenze], AZ Klina, Clinical Center of Serbia (KCS), University of Belgrade [Belgrade], Sultan Qaboos University Hospital, Partenaires INRAE, Hospital Universitario de Salamanca, Servicio de Haematologia, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), University of Wrocław [Poland] (UWr), San Bortolo Hospital, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Hospital Universitario 12 de Octubre [Madrid], Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Universidad Rey Juan Carlos [Madrid] (URJC), University of Basel (Unibas), Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), University Hospital Kralovské Vinohrady, Centre Hospitalier de Versailles André Mignot (CHV), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut de Génétique Moléculaire de Montpellier (IGMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Département Hématologie biologique [CHRU Montpellier], Pôle Biologie-Pathologie [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Universidade Federal do Estado do Rio de Janeiro (UNIRIO), San Gerardo Hospital of Monza, Oxford NIHR Biomedical Research Centre, IRCCS Ospedale San Raffaele [Milan, Italy], Assi Sette Llaghi Varese, Instituto Português de Oncologia do Porto / Portuguese Oncology Institute of Porto (IPO Porto), University Hospital Olomouc [Czech Republic], ASST Grande Ospedale Metropolitano Niguarda, University Hospital Centre Zagreb, Instituto Nacional do Câncer, Copenhagen University Hospital, Republican Scientific and Practical Center (RSPC) for organ and Tissue Transplantation, Minsk, Republican Scientific and Practical Center (RSPC) for Organ and Transplantation, German Centre for Infection Research (DZIF), Gilead Sciences, Pagano, Livio [0000-0001-8287-928X], Salmanton-García, Jon [0000-0002-6766-8297], Marchesi, Francesco [0000-0001-6353-2272], Busca, Alessandro [0000-0001-5361-5613], Corradini, Paolo [0000-0002-9186-1353], Hoenigl, Martin [0000-0002-1653-2824], Klimko, Nikolay [0000-0001-6095-7531], Koehler, Philipp [0000-0002-7386-7495], Pagliuca, Antonio [0000-0003-2519-0333], Passamonti, Francesco [0000-0001-8068-5289], Verga, Luisa [0000-0003-1142-8435], Víšek, Benjamin [0000-0001-8268-452X], Ilhan, Osman [0000-0003-1665-372X], Weinbergerová, Barbora [0000-0001-6460-2471], Córdoba, Raúl [0000-0002-7654-8836], Marchetti, Monia [0000-0001-7615-0572], Farina, Francesca [0000-0002-5124-6970], Cattaneo, Chiara [0000-0003-0031-3237], Cabirta, Alba [0000-0001-7198-8894], Gomes-Silva, Maria [0000-0002-6993-2450], Itri, Federico [0000-0002-3532-5281], Doesum, Jaap van [0000-0003-0214-3219], Ledoux, Marie-Pierre [0000-0002-3261-3616], Čerňan, Martin [0000-0003-2345-1229], Jakšić, Ozren [0000-0003-4026-285X], Magliano, Gabriel [0000-0002-9129-1530], Omrani, Ali S. [0000-0001-5309-6358], Fracchiolla, Nicola S. [0000-0002-8982-8079], Kulasekararaj, Austin G. [0000-0003-3180-3570], Valković, Toni [0000-0001-6083-8815], Poulsen, Christian Bjørn [0000-0001-9785-1378], Machado, Marina [0000-0002-8370-2248], Glenthøj, Andrea [0000-0003-2082-0738], Stoma, Igor [0000-0003-0483-7329], Ráčil, Zdeněk [0000-0003-3511-4596], Piukovics, Klára [0000-0003-4480-3131], Emarah, Ziad [0000-0003-0622-2598], Sili, Uluhan [0000-0002-9939-9298], Maertens, Johan [0000-0003-4257-5980], Bergantim, Rui [0000-0002-7811-9509], García-Vidal, Carolina [0000-0002-8915-0683], Prezioso, Lucia [0000-0003-1660-4960], Principe, Maria Ilaria del [0000-0002-3958-0669], Popova, Marina [0000-0001-8536-5495], Jonge, Nick de [0000-0002-9901-0887], Ormazabal-Vélez, Irati [0000-0003-1141-5546], Falces-Romero, Iker [0000-0001-5888-7706], Cuccaro, Annarosa [0000-0002-0237-1839], Meers, Stef [0000-0003-1754-2175], Buquicchio, Caterina [0000-0002-3683-5953], Antić, Darko [0000-0002-2608-1342], Al-Khabori, Murtadha [0000-0002-2937-8838], García-Sanz, Ramón [0000-0003-4120-2787], Biernat, Monika [0000-0003-3161-3398], Tisi, Maria Chiara [0000-0001-8231-6700], Sal, Ertan [0000-0003-2761-2675], Rahimli, Laman [0000-0003-2266-445X], Schönlein, Martin [0000-0002-1010-0975], Calbacho, María [0000-0001-8106-4863], Tascini, Carlo [0000-0001-9625-6024], Miranda-Castillo, Carolina [0000-0001-8763-9576], Khanna, Nina [0000-0002-2642-419X], Méndez, Gustavo-Adolfo [0000-0003-0514-7004], Petzer, Verena [0000-0002-9205-1440], Besson, Caroline [0000-0003-4364-7173], Duléry, Rémy [0000-0002-5024-1713], Lamure, Sylvain [0000-0001-5980-305X], Nucci, Marcio [0000-0003-4867-0014], Zambrotta, Giovanni [0000-0002-8612-2994], Žák, Pavel [0000-0003-4465-5343], Cengiz Seval, Guldane [0000-0001-9433-2054], Bonuomo, Valentina [0000-0001-6491-8337], Mayer, Jiří [0000-0003-0567-9887], López-García, Alberto [0000-0002-5354-5261], Sacchi, Maria Vittoria [0000-0001-8133-3357], Booth, Stephen [0000-0003-2687-0234], Ciceri, Fabio [0000-0003-0873-0123], Nunes-Rodrigues, Raquel [0000-0002-8347-4281], Ammatuna, Emanuele [0000-0001-8247-4901], Obr, Aleš [0000-0002-6758-3074], Herbrecht, Raoul [0000-0002-9381-4876], Shwaylia, Hawraa [0000-0002-4098-6092], Sciumè, Mariarita [0000-0001-7958-4966], Essame, Jenna [0000-0003-0926-5577], Batinić, Josip [0000-0001-5595-9911], Gonzaga, Yung [0000-0003-1416-2118], Regalado-Artamendi, Isabel [0000-0002-9673-9015], Karlsson, Linda Katharina [0000-0003-3317-7550], Shapetska, Maryia [0000-0002-1223-9161], El-Ashwah, Shaimaa [0000-0003-2210-1534], Çolak, Gökçe Melis [0000-0002-7662-7454], Dragonetti, Giulia [0000-0003-1775-6333], Rinaldi, Amelia [0000-0002-8211-5076], Ramón, Cristina de [0000-0002-8167-6410], Cornely, Oliver A. [0000-0001-9599-3137], Institut Català de la Salut, [Pagano L] Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS – Università Cattolica del Sacro Cuore, Rome, Italy. Università Cattolica del Sacro Cuore, Rome, Italy. [Salmanton-García J] Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Excellence Center for Medical Mycology (ECMM), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. Cologne Excellence Cluster On Cellular Stress Responses in Aging Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. [Marchesi F] Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy. [Busca A] Stem Cell Transplant Center, AOU Citta’ Della Salute E Della Scienza, Turin, Italy. [Corradini P] University of Milan and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy. [Hoenigl M] Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA. Clinical and Translational Fungal Working Group, University of California San Diego, La Jolla, CA, USA. Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria. [Cabirta A, Izuzquiza M] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, Hematology, Salmanton-García, Jon, Klimko, Nikolay, Víšek, Benjamin, Weinbergerová, Barbora, Córdoba, Raúl, Doesum, Jaap van, Čerňan, Martin, Jakšić, Ozren, Magliano, Gabriel, Kulasekararaj, Austin G., Valković, Toni, Poulsen, Christian Bjørn, Glenthøj, Andrea, Ráčil, Zdeněk, Piukovics, Klára, García-Vidal, Carolina, Principe, Maria Ilaria del, Jonge, Nick de, Ormazabal-Vélez, Irati, Antić, Darko, García-Sanz, Ramón, Biernat, Monika, Schönlein, Martin, Calbacho, María, Méndez, Gustavo-Adolfo, Duléry, Rémy, Žák, Pavel, Cengiz Seval, Guldane, Mayer, Jiří, López-García, Alberto, Obr, Aleš, Sciumè, Mariarita, Batinić, Josip, Çolak, Gökçe Melis, Ramón, Cristina de, and Universidad de Sevilla. Departamento de Medicina

Subjects
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology, Male, Cancer Research, MESH: Registries, Epidemiology, MESH: Hospitalization, Hematological malignancies, Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores], MESH: Aged, 80 and over, MESH: Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Risk Factors, Malalties - Factors de risc, Risk of mortality, Medicine and Health Sciences, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], 80 and over, Medicine, MESH: COVID-19, Registries, Sang - Malalties - Complicacions, RC254-282, Cause of death, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, MESH: Aged, Aged, 80 and over, Hematology, MESH: Middle Aged, Mortality rate, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Myeloid leukemia, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Middle Aged, CANCER, Europe, Hospitalization, Intensive Care Units, Oncology, MESH: Young Adult, Hematologic Neoplasms, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Infektologija, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, COVID-19, EHA, Pandemic, Aged, Humans, SARS-CoV-2, Young Adult, técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], [SDV.CAN] Life Sciences [q-bio]/Cancer, Intensive care, Internal medicine, Diseases of the blood and blood-forming organs, MESH: SARS-CoV-2, neoplasias::neoplasias por localización::neoplasias hematológicas [ENFERMEDADES], Molecular Biology, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, pandemic, hematological malignancies, epidemiology, MESH: Humans, Science & Technology, business.industry, Myelodysplastic syndromes, Research, MESH: Adult, Neoplasms::Neoplasms by Site::Hematologic Neoplasms [DISEASES], medicine.disease, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Infectology, Settore MED/15, MESH: Male, Settore MED/15 - MALATTIE DEL SANGUE, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, COVID-19 (Malaltia) - Diagnòstic, MESH: Intensive Care Units, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], MESH: Europe, RC633-647.5, business, MESH: Female, Other subheadings::Other subheadings::/complications [Other subheadings], MESH: Hematologic Neoplasms
Abstract

Background Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value, EPICOVIDEHA has received funds from Optics COMMITTM (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).

Published
2021
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13. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium

Author

Oliver A. Cornely, Joseph Meletiadis, Joerg J. Vehreschild, Abdullah M. S. Al-Hatmi, Martin Hoenigl, Ban Hock Tan, Malcolm Richardson, Alexandro Bonifaz, Zdenek Racil, Monica A. Slavin, Henrik Jeldtoft Jensen, Janos Sinko, Arunaloke Chakrabarti, Dora E. Corzo-Leon, Souha S. Kanj, Alessandro C. Pasqualotto, Rita O. Oladele, Arnaldo Lopes Colombo, William J. Steinbach, Ronen Ben-Ami, Livio Pagano, Ashraf S. Ibrahim, Georg Maschmeyer, Jacques F. Meis, Zoi D. Pana, Neeraj Sidharthan, Methee Chayakulkeeree, Atul Patel, Nina Singh, Seyedmojtaba Seyedmousavi, Sharon C.-A. Chen, Brad Spellberg, Dong-Gun Lee, Maria J G T Vehreschild, Frédéric Lamoth, Andreas H. Groll, Sevtap Arikan-Akdagli, Marcio Nucci, Andrew J. Ullmann, Katrien Lagrou, Rajeev Soman, Danila Seidel, Thomas J. Walsh, Roger Wahba, Nikolay Klimko, Fanny Lanternier, Badre E. Lmimouni, Sibylle C. Mellinghoff, P. Lewis White, Stéphane Bretagne, Murat Akova, Emmanuel Roilides, Ana Alastruey-Izquierdo, Alexandre Alanio, Cornelia Lass-Floerl, Markus Ruhnke, Anna Skiada, Mihai Mares, Eric Dannaoui, Mervyn Mer, Hamid Badali, Bruno Hochhegger, Thomas Lehrnbecher, Dorothee Arenz, C. Orla Morrissey, Elio Castagnola, Jesús Guinea, Lubos Drgona, Russell E. Lewis, Nathan P. Wiederhold, Michaela Lackner, Claus Peter Heussel, Theoklis E. Zaoutis, Donald C. Sheppard, University Hospital of Cologne [Cologne], Instituto de Salud Carlos III [Madrid] (ISC), The University of Sydney, Unité de Parasitologie-Mycologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Cité (UPCité), University of California [San Diego] (UC San Diego), University of California (UC), Medical University Graz, University Hospitals Leuven [Leuven], University of the Witwatersrand [Johannesburg] (WITS), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases - CECAD [Cologne, Germany] (Institute for Genetics), University of Cologne, German Centre for Infection Research (DZIF), McGill University = Université McGill [Montréal, Canada], Hacettepe University School of Medicine, Mycologie moléculaire - Molecular Mycology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals (CNRMA), Institut Pasteur [Paris] (IP), Radboud University Medical Center [Nijmegen], Ankara University School of Medicine [Turkey], Department of Infectious Diseases and Tropical Medicine [Paris], Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5), Medical Microbiology & Infectious Diseases, Cornely O.A., Alastruey-Izquierdo A., Arenz D., Chen S.C.A., Dannaoui E., Hochhegger B., Hoenigl M., Jensen H.E., Lagrou K., Lewis R.E., Mellinghoff S.C., Mer M., Pana Z.D., Seidel D., Sheppard D.C., Wahba R., Akova M., Alanio A., Al-Hatmi A.M.S., Arikan-Akdagli S., Badali H., Ben-Ami R., Bonifaz A., Bretagne S., Castagnola E., Chayakulkeeree M., Colombo A.L., Corzo-Leon D.E., Drgona L., Groll A.H., Guinea J., Heussel C.-P., Ibrahim A.S., Kanj S.S., Klimko N., Lackner M., Lamoth F., Lanternier F., Lass-Floerl C., Lee D.-G., Lehrnbecher T., Lmimouni B.E., Mares M., Maschmeyer G., Meis J.F., Meletiadis J., Morrissey C.O., Nucci M., Oladele R., Pagano L., Pasqualotto A., Patel A., Racil Z., Richardson M., Roilides E., Ruhnke M., Seyedmousavi S., Sidharthan N., Singh N., Sinko J., Skiada A., Slavin M., Soman R., Spellberg B., Steinbach W., Tan B.H., Ullmann A.J., Vehreschild J.J., Vehreschild M.J.G.T., Walsh T.J., White P.L., Wiederhold N.P., Zaoutis T., and Chakrabarti A.

Subjects
0301 basic medicine, medicine.medical_specialty, Posaconazole, [SDV]Life Sciences [q-bio], 030106 microbiology, MEDLINE, Disease, mucormycosis, guideline, diagnosis, treatment, mucormycosis, Article, 03 medical and health sciences, 0302 clinical medicine, Amphotericin B deoxycholate, Medicine, Humans, 030212 general & internal medicine, Disease management (health), Intensive care medicine, business.industry, Mucormycosis, Disease Management, Guideline, medicine.disease, Settore MED/15 - MALATTIE DEL SANGUE, Infectious Diseases, business, medicine.drug, Rare disease
Abstract

BackgroundMucormycosis is a difficult to diagnose rare disease with high morbidity and mortality. Diagnosis is often delayed, and disease tends to progress rapidly. Urgent surgical and medical intervention is lifesaving. Guidance on the complex multidisciplinary management has potential to improve prognosis, but approaches differ between health care settings.MethodsFrom January 2018, authors from 33 countries in all United Nations regions analysed the published evidence on mucormycosis management and provided consensus recommendations addressing differences between the regions of the world as part of the “One World One Guideline” initiative of the European Confederation of Medical Mycology (ECMM). The author group based in 17 time zones, relied on electronic media including video tutorial on methodology, and central document repository with several daily updates.FindingsSigns and symptoms of mucormycosis depend on organ patterns and underlying conditions. Diagnostic management does not differ greatly between world regions. Upon suspicion of mucormycosis appropriate imaging is strongly recommended to document extent of disease and is followed by strongly recommended surgical intervention. First-line treatment with high-dose liposomal amphotericin B is strongly recommended, while intravenous isavuconazole and intravenous or delayed release tablet posaconazole are recommended with moderate strength. Both triazoles are strongly recommended salvage treatments. Amphotericin B deoxycholate is recommended against, because of substantial toxicity, but may be the only option in resource limited settings.InterpretationManagement of mucormycosis depends on recognising disease patterns and on early diagnosis. Limited availability of contemporary treatments burdens patients in low and middle income settings. Areas of uncertainty were identified and future research directions specified.

Published
2019
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14. Toxoplasmosis in Transplant Recipients, Europe, 2010-2014

Author

Hervé Pelloux, Isabelle Accoceberry, Effrossyni Gkrania-Klotsas, Zoi Dorothea Pana, Marie-Pierre Brenier-Pinchart, Hamdi Akan, Damien Dupont, Jordi Carratalà, María Carmen Fariñas, Jose-Manuel Garcia, Lubos Drgona, Isabella Abbate, Miruna D. David, Christian van Delden, Isabelle Villena, Fabrizio Bruschi, Tijana Štajner, Lia Monica Junie, Cédric Hirzel, Edward Guy, Nina Khanna, Oscar Len, Valeria Meroni, Florence Robert-Gangneux, Andreas H. Groll, Patricia Muñoz, Tiziana Lazzarotto, Françoise Botterel, Özgür Kurt, Katia Boggian, Nicolas J. Mueller, Francesca Genco, Olgica Djurković-Djaković, Oriol Manuel, Emmanuel Roilides, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Epidémiosurveillance de protozooses à transmission alimentaire et vectorielle (ESCAPE), Université de Reims Champagne-Ardenne (URCA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Centre Hospitalier Universitaire de Reims (CHU Reims), Universitat de Barcelona, Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Reims Champagne-Ardenne (URCA), and Robert-Gangneux F, Meroni V, Dupont D, Botterel F, Garcia JMA, Brenier-Pinchart MP, Accoceberry I, Akan H, Abbate I, Boggian K, Bruschi F, Carratalà J, David M, Drgona L, Djurković-Djaković O, Farinas MC, Genco F, Gkrania-Klotsas E, Groll AH, Guy E, Hirzel C, Khanna N, Kurt Ö, Junie LM, Lazzarotto T, Len O, Mueller NJ, Munoz P, Pana ZD, Roilides E, Stajner T, van Delden C, Villena I, Pelloux H, Manuel O

Subjects
0301 basic medicine, Pediatrics, Epidemiology, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lcsh:Medicine, Hematopoietic stem cell transplantation, Chemoprophylaxis, Toxoplasmosis in Transplant Recipients, Europe, 2010–2014, Organ transplantation, 0302 clinical medicine, Risk Factors, Antibiotics, 030212 general & internal medicine, hematopoietic stem cell transplant, toxoplasma infection, ComputingMilieux_MISCELLANEOUS, cerebral toxoplasmosis, Cerebral toxoplasmosis, education.field_of_study, ddc:617, Hematopoietic Stem Cell Transplantation, Middle Aged, 3. Good health, Europe, Infectious Diseases, Electronic data, Hematopoietic stem cell transplant, Europa, Toxoplasma, Toxoplasmosis, Adult, Microbiology (medical), medicine.medical_specialty, Paràsits, 030106 microbiology, Population, Antibiòtics, parasites, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, transplant recipient, medicine, Humans, lcsh:RC109-216, Parasites, education, Survival rate, Retrospective Studies, Toxoplasma infection, Transplantation, business.industry, Research, lcsh:R, chemoprophylaxis, Organ Transplantation, medicine.disease, Transplant Recipients, cotrimoxazole, transplantation, Cotrimoxazole, business, Toxoplasmosi gondii, prevention practices, prevalence, outcomes, hematopoietic stem cell transplant, solid organ transplant, Transplant recipient
Abstract

Transplantation activity is increasing, leading to a growing number of patients at risk for toxoplasmosis. We reviewed toxoplasmosis prevention practices, prevalence, and outcomes for hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT; heart, kidney, or liver) patients in Europe. We collected electronic data on the transplant population and prevention guidelines/regulations and clinical data on toxoplasmosis cases diagnosed during 2010-2014. Serologic pretransplant screening of allo-hematopoietic stem cell donors was performed in 80% of countries, screening of organ donors in 100%. SOT recipients were systematically screened in 6 countries. Targeted anti-Toxoplasma chemoprophylaxis was heterogeneous. A total of 87 toxoplasmosis cases were recorded (58 allo-HSCTs, 29 SOTs). The 6-month survival rate was lower among Toxoplasma-seropositive recipients and among allo-hematopoietic stem cell and liver recipients. Chemoprophylaxis improved outcomes for SOT recipients. Toxoplasmosis remains associated with high mortality rates among transplant recipients. Guidelines are urgently needed to standardize prophylactic regimens and optimize patient management.

Published
2018
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15. The use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis: recommendations from the Third European Conference on Infections in Leukemia

Author

Stéphane Bretagne, Maurizio Sanguinetti, Paul Verweij, Janos Sinko, MALGORZATA MIKULSKA, Nikolay Klimko, Thierry Calandra, Frederic Lamoth, Malcolm Richardson, Daniel Poulain, Maiken Cavling Arendrup, Division of Infectious Diseases, San Martino University Hospital, nfectious Diseases Service, Université de Lausanne (UNIL)-Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Istituto di Microbiologia - Institute of Microbiology [Rome], Università cattolica del Sacro Cuore [Piacenza e Cremona] (Unicatt), Physiopathologie des Candidoses, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, University of Genoa (UNIGE)-San Martino University Hospital, the Third European Conference on Infections in Leukemia Group, Université de Lausanne = University of Lausanne (UNIL)-Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Università degli studi di Genova = University of Genoa (UniGe)-San Martino University Hospital, BMC, Ed., Third European Conference on Infections in Leukemia Group, Akova, M., Arendrup, M., Barnes, R., Bille, J., Bretagne, S., Calandra, T., Castagnola, E., Cordonnier, C., Cornely, OA., Cruciani, M., Cuenca-Estrella, M., Dannaoui, E., De La Camara, R., Dellow, E., Donnelly, P., Drgona, L., Einsele, H., Engelhard, D., Flückiger, U., Gachot, B., Gonzales-Moreno, J., Groll, A., Hanel, I., Herbrecht, R., Heussel, CP., Jones, B., Kibbler, C., Klimko, N., Klingspor, L., Kouba, M., Lamoth, F., Lanternier, F., Lehrnbecher, T., Loeffler, J., Lortholary, O., Maertens, J., Marchetti, O., Maschan, A., Mikulska, M., Pagano, L., Petrikos, G., Poulain, D., Racil, Z., Reusser, P., Ribaud, P., Richardson, M., Rizzi-Puechal, V., Ruhnke, M., Sanguinetti, M., Sinko, J., Skiada, A., Styczynski, J., Thiebaut, A., Verweij, P., Viscoli, C., Wahl, J., Ward, K., and White, P.

Subjects
[SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Critical Care and Intensive Care Medicine, Gastroenterology, Serology, law.invention, Mannans, 0302 clinical medicine, MESH: Practice Guidelines as Topic, law, Medicine, MESH: Animals, 030212 general & internal medicine, Candida, Randomized Controlled Trials as Topic, Mannan, 0303 health sciences, Leukemia, mannan, Intensive care unit, 3. Good health, Europe, Practice Guidelines as Topic, medicine.medical_specialty, Antigens, Fungal, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, Animals, Antibodies, Fungal/biosynthesis, Antigens, Fungal/immunology, Candida/immunology, Candidiasis, Invasive/diagnosis, Candidiasis, Invasive/immunology, Congresses as Topic, Humans, Leukemia/complications, Leukemia/immunology, Mannans/immunology, Practice Guidelines as Topic/standards, Randomized Controlled Trials as Topic/standards, 03 medical and health sciences, MESH: Mannans, MESH: Candida, Internal medicine, MESH: Leukemia, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Candidiasis, Invasive, Antibodies, Fungal, MESH: Antigens, Fungal, MESH: Humans, 030306 microbiology, business.industry, Research, MESH: Antibodies, Fungal, Cancer, Odds ratio, medicine.disease, Confidence interval, MESH: Candidiasis, Invasive, MESH: Randomized Controlled Trials as Topic, Immunology, Diagnostic odds ratio, MESH: Europe, business, MESH: Congresses as Topic
Abstract

International audience; INTRODUCTION: Timely diagnosis of invasive candidiasis (IC) remains difficult as the clinical presentation is not specific and blood cultures lack sensitivity and need a long incubation time. Thus, non-culture-based methods for diagnosing IC have been developed. Mannan antigen (Mn) and anti-mannan antibodies (A-Mn) are present in patients with IC. On behalf of the Third European Conference on Infections in Leukemia, the performance of these tests was analysed and reviewed. METHODS: The literature was searched for studies using the commercially available sandwich enzyme-linked immunosorbent assays (Platelia™, Bio-Rad Laboratories, Marnes-la-Coquette, France) for detecting Mn and A-Mn in serum. The target condition of this review was IC defined according to 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity, specificity and diagnostic odds ratios (DOR) were calculated for Mn, A-Mn and combined Mn/A-Mn testing. RESULTS: Overall, 14 studies that comprised 453 patients and 767 controls were reviewed. The patient populations included in the studies were mainly haematological and cancer cases in seven studies and mainly intensive care unit and surgery cases in the other seven studies. All studies but one were retrospective in design. Mn sensitivity was 58% (95% confidence interval [CI], 53-62); specificity, 93% (95% CI, 91-94) and DOR, 18 (95% CI 12-28). A-Mn sensitivity was 59% (95% CI, 54-65); specificity, 83% (95% CI, 79-97) and DOR, 12 (95% CI 7-21). Combined Mn/A-Mn sensitivity was 83% (95% CI, 79-87); specificity, 86% (95% CI, 82-90) and DOR, 58 (95% CI 27-122). Significant heterogeneity of the studies was detected. The sensitivity of both Mn and A-Mn varied for different Candida species, and it was the highest for C. albicans, followed by C. glabrata and C. tropicalis. In 73% of 45 patients with candidemia, at least one of the serological tests was positive before the culture results, with mean time advantage being 6 days for Mn and 7 days for A-Mn. In 21 patients with hepatosplenic IC, 18 (86%) had Mn or A-Mn positive test results at a median of 16 days before radiological detection of liver or spleen lesions. CONCLUSIONS: Mn and A-Mn are useful for diagnosis of IC. The performance of combined Mn/A-Mn testing is superior to either Mn or A-Mn testing.

Published
2010
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