Clinical characteristics and mortality of mucormycosis in hematological malignancies: a retrospective study in Eastern China.

IF 4.6 2区 医学 Q1 MICROBIOLOGY
Tao Suo, Mengmeng Xu, Qixia Xu
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引用次数: 0

Abstract

Background: Mucormycosis is a significant cause of morbidity and mortality in patients with hematological malignancies, but its characteristics are not fully understood. This study aimed to gain a better understanding of the clinical features of mucormycosis in patients with hematological malignancies in eastern China.

Methods: A single-center retrospective analysis was conducted on the demographic profile, microbiology, management, and 90-day mortality of mucormycosis patients with hematological malignancies between 2018 and 2023.

Results: A total of 50 cases were included in the study, consisting of 11 proven and 39 probable cases of mucormycosis. The median age of the patients was 39.98 ± 18.52 years, with 52% being male. Among the cases, 46% had acute myeloid leukemia (AML), 16% had acute lymphoblastic leukemia (ALL), and 16% had myelodysplastic syndrome. The most common manifestations of mucormycosis were pulmonary (80%), disseminated (16%), and rhinocerebral (4%). The diagnosis was confirmed through histology, culture, microscopy, and molecular diagnostic techniques. The most commonly identified fungal species were Cunninghamella (40%), Rhizopus (26%), and Rhizomucor (22%). Treatment involved antifungals in 84% of cases and surgery in 10% of cases. The 90-day mortality rate was 76%. Logistic regression analysis revealed that treatment with amphotericin B and surgery was associated with improved survival, while neutropenia and administration of voriconazole prior to diagnosis was associated with higher mortality.

Conclusions: Mucormycosis continues to have a high mortality rate in patients with hematological malignancies. Early diagnosis using various techniques, including molecular biology, along with the appropriate use of amphotericin B and surgery when possible, is vital for the successful treatment of mucormycosis.

血液恶性肿瘤粘液瘤病的临床特征和死亡率:华东地区的回顾性研究。
背景:粘孢子菌病是血液恶性肿瘤患者发病和死亡的一个重要原因,但其特征尚未完全清楚。本研究旨在更好地了解华东地区血液恶性肿瘤患者粘孢子菌病的临床特点:对2018年至2023年间血液系统恶性肿瘤粘孢子菌病患者的人口学特征、微生物学、管理和90天死亡率进行单中心回顾性分析:研究共纳入50例病例,包括11例确诊粘孢子菌病病例和39例疑似病例。患者的中位年龄为(39.98±18.52)岁,52%为男性。病例中,46%患有急性髓细胞白血病(AML),16%患有急性淋巴细胞白血病(ALL),16%患有骨髓增生异常综合征。粘液瘤病最常见的表现是肺部(80%)、播散(16%)和鼻脑部(4%)。通过组织学、培养、显微镜和分子诊断技术确诊。最常鉴定出的真菌种类是坤宁汉姆菌(40%)、根霉(26%)和根霉菌(22%)。84%的病例采用抗真菌药物治疗,10%的病例采用手术治疗。90 天死亡率为 76%。逻辑回归分析显示,两性霉素B和手术治疗与生存率的提高有关,而中性粒细胞减少症和诊断前服用伏立康唑与死亡率的升高有关:结论:在血液恶性肿瘤患者中,粘孢子菌病的死亡率仍然很高。采用包括分子生物学在内的各种技术进行早期诊断,同时适当使用两性霉素 B,并在可能的情况下进行手术,对于成功治疗粘孢子菌病至关重要。
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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
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