血液系统恶性肿瘤患者的侵袭性真菌感染:流行病学和预后因素。

IF 0.9 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pan African Medical Journal Pub Date : 2024-07-24 eCollection Date: 2024-01-01 DOI:10.11604/pamj.2024.48.130.40509
Maroua Jebari, Latifa Mtibaa, Hela Ghedira, Nawel Baccouchi, Sami Zriba, Fehmi Msadek, Boutheina Jemli
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引用次数: 0

摘要

侵袭性真菌感染(IFI)是一种新出现的机会性疾病,主要发生在免疫力低下的患者身上。我们的研究旨在分析血液恶性肿瘤患者中侵袭性真菌感染的流行病学及其预后因素。我们的回顾性研究纳入了 2010 年 1 月 1 日至 2020 年 8 月 31 日期间在血液科住院的患者,这些患者根据 2008 年 EORTC 标准被诊断为 IFI。我们在 6989 例住院患者中发现了 29 例 IFI(0.4%)。其中 16 例确诊为 IFI,13 例可能为 IFI。中位年龄为 35 岁。性别比为 0.9。最主要的 IFI 是侵袭性肺曲霉菌病(14 例),其次是真菌血症(13 例)。白色念珠菌是血液培养中分离最多的菌种(5/9)。死亡率为 48%。在多变量分析中,疾病状态、开始抗真菌治疗的时间和乳酸水平是导致死亡率过高的重要因素。肠道感染是导致严重发病和死亡的重要原因。面临的挑战在于如何及早开始治疗,并对预后不良的因素保持警惕。
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Invasive fungal infection in patients with hematologic malignancies: epidemiology and prognostic factors.

Invasive fungal infections (IFI) are emerging opportunistic diseases that occur mainly in immunocompromised patients. Our study aimed to analyze the epidemiology of IFIs in patients with hematological malignancies, and the prognostic factors. Our retrospective study included patients hospitalized in the hematology department between January 1st, 2010, and August 31st, 2020, and in whom the diagnosis of IFI was made according to the EORTC criteria 2008. We found 29 IFIs among 6989 admissions (0.4%). IFIs were proven in 16 cases and probable in 13 cases. The median age was 35 years. The sex ratio was 0.9. The predominant IFI was invasive pulmonary aspergillosis (n=14) followed by fungemia (n=13). Candida albicans was the most isolated species in blood cultures (5/9). The mortality rate was 48%. In multivariate analysis, disease status, time to start antifungal treatment, and lactate levels are significant factors of excess mortality. IFIs are responsible for significant morbidity and mortality. The challenge lies in the precocity of starting the treatment as well as the vigilance given to the factors of poor prognosis.

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Pan African Medical Journal
Pan African Medical Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
1.80
自引率
0.00%
发文量
691
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