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Five-years surveillance of invasive aspergillosis in a university hospital

BACKGROUND: As the most common invasive fungal infection, invasive aspergillosis (IA) remains a serious complication in immunocompromised patients, leading to increased mortality. Antifungal therapy is expensive and may result in severe adverse effects. The aim of this study was to determine the inc...

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Autores principales: Graf, Karolin, Khani, Somayeh Mohammad, Ott, Ella, Mattner, Frauke, Gastmeier, Petra, Sohr, Dorith, Ziesing, Stefan, Chaberny, Iris F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128051/
https://www.ncbi.nlm.nih.gov/pubmed/21651773
http://dx.doi.org/10.1186/1471-2334-11-163
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author Graf, Karolin
Khani, Somayeh Mohammad
Ott, Ella
Mattner, Frauke
Gastmeier, Petra
Sohr, Dorith
Ziesing, Stefan
Chaberny, Iris F
author_facet Graf, Karolin
Khani, Somayeh Mohammad
Ott, Ella
Mattner, Frauke
Gastmeier, Petra
Sohr, Dorith
Ziesing, Stefan
Chaberny, Iris F
author_sort Graf, Karolin
collection PubMed
description BACKGROUND: As the most common invasive fungal infection, invasive aspergillosis (IA) remains a serious complication in immunocompromised patients, leading to increased mortality. Antifungal therapy is expensive and may result in severe adverse effects. The aim of this study was to determine the incidence of invasive aspergillosis (IA) cases in a tertiary care university hospital using a standardized surveillance method. METHODS: All inpatients at our facility were screened for presence of the following parameters: positive microbiological culture, pathologist's diagnosis and antifungal treatment as reported by the hospital pharmacy. Patients fulfilling one or more of these indicators were further reviewed and, if appropriate, classified according to international consensus criteria (EORTC). RESULTS: 704 patients were positive for at least one of the indicators mentioned above. Applying the EORTC criteria, 214 IA cases were detected, of which 56 were proven, 25 probable and 133 possible. 44 of the 81 (54%) proven and probable cases were considered health-care associated. 37 of the proven/probable IA cases had received solid organ transplantation, an additional 8 had undergone stem cell transplantation, and 10 patients were suffering from some type of malignancy. All the other patients in this group were also suffering from severe organic diseases, required long treatment and experienced several clinical complications. 7 of the 56 proven cases would have been missed without autopsy. After the antimycotic prophylaxis regimen was altered, we noticed a significant decrease (p = 0.0004) of IA during the investigation period (2003-2007). CONCLUSION: Solid organ and stem cell transplantation remain important risk factors for IA, but several other types of immunosuppression should also be kept in mind. Clinical diagnosis of IA may be difficult (in this study 13% of all proven cases were diagnosed by autopsy only). Thus, we confirm the importance of IA surveillance in all high-risk patients.
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spelling pubmed-31280512011-07-01 Five-years surveillance of invasive aspergillosis in a university hospital Graf, Karolin Khani, Somayeh Mohammad Ott, Ella Mattner, Frauke Gastmeier, Petra Sohr, Dorith Ziesing, Stefan Chaberny, Iris F BMC Infect Dis Research Article BACKGROUND: As the most common invasive fungal infection, invasive aspergillosis (IA) remains a serious complication in immunocompromised patients, leading to increased mortality. Antifungal therapy is expensive and may result in severe adverse effects. The aim of this study was to determine the incidence of invasive aspergillosis (IA) cases in a tertiary care university hospital using a standardized surveillance method. METHODS: All inpatients at our facility were screened for presence of the following parameters: positive microbiological culture, pathologist's diagnosis and antifungal treatment as reported by the hospital pharmacy. Patients fulfilling one or more of these indicators were further reviewed and, if appropriate, classified according to international consensus criteria (EORTC). RESULTS: 704 patients were positive for at least one of the indicators mentioned above. Applying the EORTC criteria, 214 IA cases were detected, of which 56 were proven, 25 probable and 133 possible. 44 of the 81 (54%) proven and probable cases were considered health-care associated. 37 of the proven/probable IA cases had received solid organ transplantation, an additional 8 had undergone stem cell transplantation, and 10 patients were suffering from some type of malignancy. All the other patients in this group were also suffering from severe organic diseases, required long treatment and experienced several clinical complications. 7 of the 56 proven cases would have been missed without autopsy. After the antimycotic prophylaxis regimen was altered, we noticed a significant decrease (p = 0.0004) of IA during the investigation period (2003-2007). CONCLUSION: Solid organ and stem cell transplantation remain important risk factors for IA, but several other types of immunosuppression should also be kept in mind. Clinical diagnosis of IA may be difficult (in this study 13% of all proven cases were diagnosed by autopsy only). Thus, we confirm the importance of IA surveillance in all high-risk patients. BioMed Central 2011-06-08 /pmc/articles/PMC3128051/ /pubmed/21651773 http://dx.doi.org/10.1186/1471-2334-11-163 Text en Copyright ©2011 Graf et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Graf, Karolin
Khani, Somayeh Mohammad
Ott, Ella
Mattner, Frauke
Gastmeier, Petra
Sohr, Dorith
Ziesing, Stefan
Chaberny, Iris F
Five-years surveillance of invasive aspergillosis in a university hospital
title Five-years surveillance of invasive aspergillosis in a university hospital
title_full Five-years surveillance of invasive aspergillosis in a university hospital
title_fullStr Five-years surveillance of invasive aspergillosis in a university hospital
title_full_unstemmed Five-years surveillance of invasive aspergillosis in a university hospital
title_short Five-years surveillance of invasive aspergillosis in a university hospital
title_sort five-years surveillance of invasive aspergillosis in a university hospital
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128051/
https://www.ncbi.nlm.nih.gov/pubmed/21651773
http://dx.doi.org/10.1186/1471-2334-11-163
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