Universität zu Köln

Koehler, Philipp ORCID: 0000-0002-7386-7495, Mellinghoff, Sibylle C., Stemler, Jannik ORCID: 0000-0001-9152-2469, Otte, Felix, Berkhoff, Ariana, Beste, Nedim, Budin, Sofia, Cornely, Florian B., Evans, Johanna M., Fuchs, Frieder ORCID: 0000-0001-7075-5378, Pesch, Luca, Rebholz, Arvid W., Reiner, Omer, Schmitt, Marius, Schuckelt, Julien, Spiertz, Arlene, Salmanton-Garcia, Jon ORCID: 0000-0002-6766-8297, Kron, Florian and Cornely, Oliver A. (2020). Quantifying guideline adherence in mucormycosis management using the EQUAL score. Mycoses, 63 (4). S. 343 - 352. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Objectives Mucormycosis is a difficult-to-diagnose life-threatening disease with high morbidity and mortality. Adherence to guidelines that lead through complex management and support clinical decisions is however rarely reported. By applying the EQUAL Score, our study evaluates the management of mucormycosis at the University Hospital of Cologne, Germany. Methods We performed a retrospective chart review of patients with mucormycosis at the University Hospital of Cologne. Data collection comprised items for quality assessment in mucormycosis management according to the EQUAL Mucormycosis Score and economics. Results Of 29 patients identified, 27 were documented retrospectively. Eight patients of 18 with neutropenia (>10 days) or receiving allogeneic stem cell transplantation (44.4%) received mould active prophylaxis. Chest CT was done in 21 patients (77.8%), while BAL and direct microscopy of BAL fluid was performed in 22 patients (81.5%), culture in 22 (81.5%) and fungal PCR in 24 (88.9%). First-line treatment was liposomal amphotericin B in 19 patients (70.4%). Isavuconazole or posaconazole with therapeutic drug monitoring was used in four (14.8%) and in one patient (3.7%), respectively. In our cohort, crude mortality was 51.9% (n = 14) with a median survival time of 113 days. During the management of the 27 patients, 450 points (53.8%) of the maximum EQUAL Mucormycosis Score were achieved (median 15 points, range 6-30). Conclusions We observed management of mucormycosis aligning with current guidelines and hope to encourage other groups to use the EQUAL Score in routine clinical settings. Future studies will evaluate whether guideline adherence in mucormycosis management improves patient outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koehler, Philipp UNSPECIFIED orcid.org/0000-0002-7386-7495 UNSPECIFIED Mellinghoff, Sibylle C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stemler, Jannik UNSPECIFIED orcid.org/0000-0001-9152-2469 UNSPECIFIED Otte, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Berkhoff, Ariana UNSPECIFIED UNSPECIFIED UNSPECIFIED Beste, Nedim UNSPECIFIED UNSPECIFIED UNSPECIFIED Budin, Sofia UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Florian B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Evans, Johanna M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Frieder UNSPECIFIED orcid.org/0000-0001-7075-5378 UNSPECIFIED Pesch, Luca UNSPECIFIED UNSPECIFIED UNSPECIFIED Rebholz, Arvid W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reiner, Omer UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmitt, Marius UNSPECIFIED UNSPECIFIED UNSPECIFIED Schuckelt, Julien UNSPECIFIED UNSPECIFIED UNSPECIFIED Spiertz, Arlene UNSPECIFIED UNSPECIFIED UNSPECIFIED Salmanton-Garcia, Jon UNSPECIFIED orcid.org/0000-0002-6766-8297 UNSPECIFIED Kron, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-348584
DOI:	10.1111/myc.13047
Journal or Publication Title:	Mycoses
Volume:	63
Number:	4
Page Range:	S. 343 - 352
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ZYGOMYCOSIS Multiple languages Dermatology; Mycology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34858