Universität zu Köln

Nucci, M., Marr, K. A., Vehreschild, M. J. G. T., de Souza, C. A., Velasco, E., Cappellano, P., Carlesse, F., Queiroz-Telles, F., Sheppard, D. C., Kindo, A., Cesaro, S., Hamerschlak, N., Solza, C., Heinz, W. J., Schaller, M., Atalla, A., Arikan-Akdagli, S., Bertz, H., Castro, C. Galvao, Jr., Herbrecht, R., Hoenigl, M., Haerter, G., Hermansen, N. E. U., Josting, A., Pagano, L., Salles, M. J. C., Mossad, S. B., Ogunc, D., Pasqualotto, A. C., Araujo, V., Troke, P. F., Lortholary, O., Cornely, O. A. and Anaissie, E. (2014). Improvement in the outcome of invasive fusariosis in the last decade. Clin. Microbiol. Infect., 20 (6). S. 580 - 586. OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

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Abstract

Invasive fusariosis (IF) has been associated with a poor prognosis. Although recent series have reported improved outcomes, the definition of optimal treatments remains controversial. The objective of this study was to evaluate changes in the outcome of IF. Weretrospectively analysed 233 cases of IF from 11 countries, comparing demographics, clinical findings, treatment and outcome in two periods: 1985-2000 (period 1) and 2001-2011 (period 2). Most patients (92%) had haematological disease. Primary treatment with deoxycholate amphotericin B was more frequent in period 1 (63% vs. 30%, p <0.001), whereas voriconazole (32% vs. 2%, p <0.001) and combination therapies (18% vs. 1%, p <0.001) were more frequent in period 2. The 90-day probabilities of survival in periods 1 and 2 were 22% and 43%, respectively (p <0.001). In period 2, the 90-day probabilities of survival were 60% with voriconazole, 53% with a lipid formulation of amphotericin B, and 28% with deoxycholate amphotericin B (p 0.04). Variables associated with poor prognosis (death 90 days after the diagnosis of fusariosis) by multivariable analysis were: receipt of corticosteroids (hazard ratio (HR) 2.11, 95% CI 1.18-3.76, p 0.01), neutropenia at end of treatment (HR 2.70, 95% CI 1.57-4.65, p <0.001), and receipt of deoxycholate amphotericin B (HR 1.83, 95% CI 1.06-3.16, p 0.03). Treatment practices have changed over the last decade, with an increased use of voriconazole and combination therapies. There has been a 21% increase in survival rate in the last decade.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nucci, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Marr, K. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, M. J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED de Souza, C. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Velasco, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cappellano, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Carlesse, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Queiroz-Telles, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sheppard, D. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kindo, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cesaro, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamerschlak, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Solza, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinz, W. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaller, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Atalla, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Arikan-Akdagli, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bertz, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Castro, C. Galvao, Jr. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbrecht, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoenigl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haerter, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hermansen, N. E. U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Josting, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pagano, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Salles, M. J. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mossad, S. B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ogunc, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pasqualotto, A. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Araujo, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Troke, P. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lortholary, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Anaissie, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-437358
DOI:	10.1111/1469-0691.12409
Journal or Publication Title:	Clin. Microbiol. Infect.
Volume:	20
Number:	6
Page Range:	S. 580 - 586
Date:	2014
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1469-0691
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INFECTIONS; SPP. Multiple languages Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43735