SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients

• DOI: 10.1007/s15010-013-0539-3
• Publication Date: 2013-10-22T08:49:33Z
• Authors: M. T. Montagna; G. Lovero; C. Coretti; D. Martinelli; M. Delia; O. De Giglio; M. Caira; F. Puntillo; D. D’Antonio; M. Venditti; V. Sambri; F. Di Bernardo; A. Barbui; G. Lo Cascio; E. Concia; M. Mikulska; C. Viscoli; N. Maximova; A. Candoni; S. Oliveri; G. Lombardi; L. Pitzurra; M. Sanguinetti; R. Masciari; T. Santantonio; S. Andreoni; F. Barchiesi; P. Pecile; C. Farina; P. Viale; G. Specchia; G. Caggiano; L. Pagano
• Keywords: Microbiology (medical); Adult; Male; Microbiological Techniques; 0301 basic medicine; Hematological patients; Adolescent; 610; Adolescent, Adult, Aged, Aged; 80 and over, Diagnostic Tests; Routine, Female, Fungi; classification/isolation /&/ purification, Hematologic Neoplasms; complications, Hospitals, Humans, Italy; epidemiology, Male, Microbiological Techniques; methods, Middle Aged, Mycoses; diagnosis/epidemiology/microbiology/mortality, Prospective Studies, Registries, Survival Analysis, Treatment Outcome, Young Adult; Clinical and Epidemiological Study; Young Adult; 03 medical and health sciences; Non-hematological patients; Filamentous fungal infections; Hematological patients; Italian survey; Non-hematological patients; Filamentous fungal infections; Italian survey; Humans; SIMIFF; aspergillosis; Prospective Studies; Registries; Aged; Aged, 80 and over; Diagnostic Tests, Routine; fungal infection; Filamentous fungal infections; Italian survey; Hematological patients; Non-hematological patients; Fungi; hematological patients; italian survey; hematological and non-hematological patients; non-hematological patients; filamentous fungal infections; italy; fungal infections; Middle Aged; Survival Analysis; Hospitals; 3. Good health; Infectious Diseases; Treatment Outcome; Italy; Mycoses; Hematologic Neoplasms; Female

We compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs).Prospective surveillance (2009-2011) of proven and probable FFIs was implemented in 23 Italian hospitals.Out of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1 % for HAEs, 56.3 % for non-HAEs), and the localization was principally pulmonary (83.2 % for HAEs, 74.8 % for non-HAEs). Neutropenia was a risk factor for 89.4 % HAEs; the main underlying condition was corticosteroid treatment (52.9 %) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1 %). The overall mortality rate was 44.2 % among the HAEs and 35.3 % among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1 % for HAEs, 77.8 % for non-HAEs).The epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients' setting.