Nucci, M., Marr, K. A., Vehreschild, M. J. G. T., de Souza, C. A., Velasco, E., Cappellano, P., Carlesse, F., Queiroz-Telles, F., Sheppard, D. C., Kindo, A., Cesaro, S., Hamerschlak, N., Solza, C., Heinz, W. J., Schaller, M., Atalla, A., Arikan-Akdagli, S., Bertz, H., Castro, C. Galvao, Jr., Herbrecht, R., Hoenigl, M., Haerter, G., Hermansen, N. E. U., Josting, A., Pagano, L., Salles, M. J. C., Mossad, S. B., Ogunc, D., Pasqualotto, A. C., Araujo, V., Troke, P. F., Lortholary, O., Cornely, O. A. and Anaissie, E. (2014). Improvement in the outcome of invasive fusariosis in the last decade. Clin. Microbiol. Infect., 20 (6). S. 580 - 586. OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

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Abstract

Invasive fusariosis (IF) has been associated with a poor prognosis. Although recent series have reported improved outcomes, the definition of optimal treatments remains controversial. The objective of this study was to evaluate changes in the outcome of IF. Weretrospectively analysed 233 cases of IF from 11 countries, comparing demographics, clinical findings, treatment and outcome in two periods: 1985-2000 (period 1) and 2001-2011 (period 2). Most patients (92%) had haematological disease. Primary treatment with deoxycholate amphotericin B was more frequent in period 1 (63% vs. 30%, p <0.001), whereas voriconazole (32% vs. 2%, p <0.001) and combination therapies (18% vs. 1%, p <0.001) were more frequent in period 2. The 90-day probabilities of survival in periods 1 and 2 were 22% and 43%, respectively (p <0.001). In period 2, the 90-day probabilities of survival were 60% with voriconazole, 53% with a lipid formulation of amphotericin B, and 28% with deoxycholate amphotericin B (p 0.04). Variables associated with poor prognosis (death 90 days after the diagnosis of fusariosis) by multivariable analysis were: receipt of corticosteroids (hazard ratio (HR) 2.11, 95% CI 1.18-3.76, p 0.01), neutropenia at end of treatment (HR 2.70, 95% CI 1.57-4.65, p <0.001), and receipt of deoxycholate amphotericin B (HR 1.83, 95% CI 1.06-3.16, p 0.03). Treatment practices have changed over the last decade, with an increased use of voriconazole and combination therapies. There has been a 21% increase in survival rate in the last decade.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Nucci, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Marr, K. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, M. J. G. T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Souza, C. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Velasco, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cappellano, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carlesse, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Queiroz-Telles, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sheppard, D. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kindo, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cesaro, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamerschlak, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Solza, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinz, W. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaller, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Atalla, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arikan-Akdagli, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bertz, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Castro, C. Galvao, Jr.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herbrecht, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoenigl, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haerter, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hermansen, N. E. U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Josting, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pagano, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Salles, M. J. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mossad, S. B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ogunc, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pasqualotto, A. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Araujo, V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Troke, P. F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lortholary, O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornely, O. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anaissie, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-437358
DOI: 10.1111/1469-0691.12409
Journal or Publication Title: Clin. Microbiol. Infect.
Volume: 20
Number: 6
Page Range: S. 580 - 586
Date: 2014
Publisher: ELSEVIER SCI LTD
Place of Publication: OXFORD
ISSN: 1469-0691
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INFECTIONS; SPP.Multiple languages
Infectious Diseases; MicrobiologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/43735

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