Clinical outcomes of aspergillosis among paediatric and adult inpatients: A multicentre study in a Brazilian metropolitan area

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale Pub Date : 2023-09-05 DOI:10.1016/j.mycmed.2023.101435

Antonio Camargo Martins , Eliane Molina Psaltikidis , Tiago Cristiano de Lima , Renata Fagnani , Hellen Caroline Alves Caldeira Gomide , Flavio Henrique Gilli , Angelica Zaninelli Schreiber , Lucieni de Oliveira Conterno , Tetsuhiro Matsuzawa , Akira Watanabe , Katsuhiko Kamei , Silvia Regina Brandalise , Plinio Trabasso , Mariângela Ribeiro Resende , Maria Luiza Moretti

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引用次数: 0

Abstract

Background

Invasive Aspergillosis (IA) is a disease of significant clinical relevance, especially among immunosuppressed patients, and is associated with high mortality rates. In this study, we evaluated the epidemiological features and clinical outcomes in children and adults with IA.

Methods

This was an observational, multicentre, prospective surveillance study of inpatients with IA at two different hospitals in Campinas, Brazil, between 2018 and 2021.

Results

A total of 44 patients were identified (54.5% males), with a median age of 42 years (interquartile range (IQR):19.25–59 years, varying between 1 and 89 years). The following baseline conditions were identified: 61.4% were oncohaematological patients and 20.5% were solid organ transplant recipients. Among oncohaematological patients, 77.8% exhibited severe or persistent neutropenia. The median time between the onset of neutropenia and the diagnosis of fungal infection was 20 days (IQR: 10.5–26 days; range, 0–68 days). The interval between neutropenia onset and fungal infection was longer in paediatric than in general hospital (average, 29 vs. 13.4 days; median 26 vs 11 days; p=0.010). After the diagnosis of IA, the survival rates were 44.2% and 30.0% at 180 and 360 days, respectively. Survival was greater in patients aged ≤ 21 years (p = 0.040; log-rank test). They observed no difference in IA mortality related to COVID-19 pandemic.

Conclusion

High mortality associated with IA was observed in both hospitals. Individuals over the age of 21 have a lower survival rate than younger patients.

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曲霉病在儿科和成人住院患者中的临床结果:巴西大都市地区的一项多中心研究

背景:侵袭性曲霉病(invasive Aspergillosis, IA)是一种具有重要临床意义的疾病，尤其是在免疫抑制患者中，并且与高死亡率相关。在这项研究中，我们评估了儿童和成人IA的流行病学特征和临床结果。方法:这是一项观察性、多中心、前瞻性监测研究，研究对象是2018年至2021年在巴西坎皮纳斯两家不同医院住院的IA患者。结果共发现44例患者，其中男性54.5%，中位年龄42岁(四分位间距(IQR):19.25 ~ 59岁，1 ~ 89岁)。确定了以下基线条件:61.4%为肿瘤血液病患者，20.5%为实体器官移植接受者。在血液肿瘤患者中，77.8%表现出严重或持续的中性粒细胞减少。中性粒细胞减少症发病至诊断为真菌感染的中位时间为20 d (IQR: 10.5-26 d;范围(0-68天)。中性粒细胞减少症发作与真菌感染之间的时间间隔在儿科比在综合医院更长(平均29天比13.4天;中位数26 vs 11天;p = 0.010)。诊断为IA后，180天和360天生存率分别为44.2%和30.0%。年龄≤21岁的患者生存率更高(p = 0.040;生存率较)。他们观察到与COVID-19大流行相关的IA死亡率没有差异。结论两家医院均有较高的IA死亡率。21岁以上患者的生存率低于年轻患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal de mycologie medicale 医学-真菌学

CiteScore

5.10

自引率

2.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal de Mycologie Medicale / Journal of Medical Mycology (JMM) publishes in English works dealing with human and animal mycology. The subjects treated are focused in particular on clinical, diagnostic, epidemiological, immunological, medical, pathological, preventive or therapeutic aspects of mycoses. Also covered are basic aspects linked primarily with morphology (electronic and photonic microscopy), physiology, biochemistry, cellular and molecular biology, immunochemistry, genetics, taxonomy or phylogeny of pathogenic or opportunistic fungi and actinomycetes in humans or animals. Studies of natural products showing inhibitory activity against pathogenic fungi cannot be considered without chemical characterization and identification of the compounds responsible for the inhibitory activity. JMM publishes (guest) editorials, original articles, reviews (and minireviews), case reports, technical notes, letters to the editor and information. Only clinical cases with real originality (new species, new clinical present action, new geographical localization, etc.), and fully documented (identification methods, results, etc.), will be considered. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.