Epidemiology and sites of involvement of invasive fungal infections in patients with haematological malignancies: a 20‐year autopsy study
Open Access
- 4 April 2013
- Vol. 56 (6), 638-645
- https://doi.org/10.1111/myc.12081
Abstract
Autopsy studies remain an essential tool for understanding the patterns of fungal disease not detected ante mortem with current diagnostic approaches. We collected data concerning the microbiological trends, patient clinical characteristics and sites of involvement for invasive fungal infections (IFIs) identified at autopsy in a single large cancer treatment centre over a 20‐year period (1989–2008). The autopsy rate and IFI prevalence both declined significantly during the study period. The prevalence of Aspergillus spp. decreased significantly from the first 15 years of the study (from 0.12 to 0.14 cases per 100 autopsies to 0.07 in 2004–2008; P = 0.04), with only Mucorales accounting for a greater proportion of IFIs over the duration of the study period (0.06 to 0.2 cases per 100 autopsies, P = 0.04). After 2003, moulds accounted for the majority of infections identified at autopsy in the spleen, kidney, heart and gastrointestinal tract. Despite a trend of decreasing prevalence from 1989 to 2004, invasive candidiasis increased in prevalence during later periods 2004–2008 (0.02–0.05 per 100 autopsies) with decreasing kidney, heart and spleen involvement. Despite a declining autopsy rate, these data suggest a decreasing prevalence overall of IFIs with changing patterns of dissemination in patients with haematological malignancies.Keywords
This publication has 33 references indexed in Scilit:
- Invasive Non-AspergillusMold Infections in Transplant Recipients, United States, 2001–2006Emerging Infectious Diseases, 2011
- High-frequency Triazole Resistance Found In Nonculturable Aspergillus fumigatus from Lungs of Patients with Chronic Fungal DiseaseClinical Infectious Diseases, 2011
- Invasive aspergillosis in patients with acute myeloid leukemia: a SEIFEM-2008 registry studyHaematologica, 2009
- Epidemiology and Outcomes of Candidemia in 2019 Patients: Data from the Prospective Antifungal Therapy Alliance RegistryClinical Infectious Diseases, 2009
- Emergence of Azole Resistance in Aspergillus fumigatus and Spread of a Single Resistance MechanismPLoS Medicine, 2008
- Caspofungin-Resistant Candida tropicalis Strains Causing Breakthrough Fungemia in Patients at High Risk for Hematologic MalignanciesAntimicrobial Agents and Chemotherapy, 2008
- Epidemiology of Invasive Mold Infections in Allogeneic Stem Cell Transplant Recipients: Biological Risk Factors for Infection According to Time after TransplantationClinical Infectious Diseases, 2008
- Revised Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus GroupClinical Infectious Diseases, 2008
- Epidemiology of Invasive Candidiasis: a Persistent Public Health ProblemClinical Microbiology Reviews, 2007
- Hematopoietic Stem-Cell TransplantationNew England Journal of Medicine, 2006