Faculty Opinions recommendation of Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.

2008 ◽  
Author(s):  
Françoise Dromer ◽  
Caroline Charlier-Woerther
Keyword(s):  
Infectious Diseases ◽  
Fungal Infections ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Invasive Fungal Infections ◽  
Study Group ◽  
Cooperative Group ◽  
European Organization ◽  
Consensus Group ◽  
Revised Definitions

scholarly journals Micafungin Compared with Caspofungin for the Treatment of Febrile Episodes in Neutropenic Patients with Hematological Malignancies: A Retrospective Study

2014 ◽  
Vol 25 (6) ◽  
pp. 299-304 ◽  
Author(s):  
Sarah Shalhoub ◽  
Luchen Wang ◽  
Arthur Ching ◽  
Shahid Husain ◽  
Coleman Rotstein
Keyword(s):  
Fungal Infection ◽  
Hematological Malignancies ◽  
Fungal Infections ◽  
Prospective Trial ◽  
Invasive Fungal Disease ◽  
Invasive Fungal Infections ◽  
Successful Outcome ◽  
European Organization ◽  
Neutropenic Patients ◽  
Revised Definitions

BACKGROUND: Invasive fungal infections are associated with morbidity and mortality in neutropenia secondary to hematological malignancies. Empirical antifungal agents are used to reduce their consequences. Caspofungin is the only echinocandin approved for this indication. Micafungin was compared with caspofungin for the treatment of patients with hematological malignancies and prolonged neutropenia.METHODS: A retrospective cohort study was conducted involving patients who had hematological malignancies with profound neutropenia for a minimum of 10 days, and received empirical micafungin or caspofungin for a minimum of five days, between April 2005 and November 2009. Successful outcome was based on a composite end point: survival for a minimum of seven days following antifungal cessation, successful treatment of baseline fungal infection, absence of adverse events and absence of breakthrough fungal infection. Fungal infections were defined according to revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC-MSG) criteria, with modification of the diagnostic imaging criteria.RESULTS: Micafungin had similar overall success to caspofungin (60.4% [29 of 48] versus 57.3% [47 of 82], respectively; P=0.729). Survival was higher in the micafungin group compared with the caspofungin group (100% [48 of 48] versus 89% [73 of 82]; P=0.02). No baseline invasive fungal infections were identified in the micafungin group, compared with three proven infections treated successfully with caspofungin (3.7%; P=0.18). Three proven breakthrough infections were observed in the micafungin group (three of 48 [27.3%]) compared with none in the caspofungin group (zero of 82; P=0.02).CONCLUSION: Micafungin has similar efficacy to caspofungin as empirical antifungal therapy in febrile neutropenic patients with hematological malignancies. Verification of these results in a prospective trial is warranted.

scholarly journals A Retrospective Study of Invasive Fungal Disease Treated by High Dosage Micafungin Therapy VS Standard Micafungin Therapy Among Patients with Hematologic Diseases.

2021 ◽  
Author(s):  
Jia Li ◽  
Ying Lv ◽  
Guojun Zhang ◽  
Rong Hu ◽  
Hong-Tao Wang
Keyword(s):  
Treatment Group ◽  
Fungal Infections ◽  
Safety Concern ◽  
Empirical Therapy ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Standard Regimen ◽  
European Organization ◽  
Treatment Groups ◽  
Empirical Antifungal Therapy

Abstract Background: The standard (150mg/day) micafungin treatment regimen, is an effective and well tolerated empirical therapy for invasive fungal disease (IFD) among hematologic patients; however, experience with high dosage (200-300mg/day) micafungin treatment is limited. We retrospectively evaluated both safety and effectiveness of micafungin as an empirical antifungal therapy via standard and high dosage treatments for IFD.Methods: Patients were considered to be qualified for this analysis if they were proven, probable, or possible diagnosed as IFD. Patients without any previous exposure to an echinocandin were included; for those who changed treatment dosages and had previously received another systemic therapy except fluconazole for prevention were excluded. Safety and effectiveness were evaluated in all participated patients. IFD was diagnosed and classified according to standards defined by both European Organization for Research and Treatment of Cancer / Invasive Fungal Infections Cooperative Group, and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group.Results: Totally 72 hematologic patients participated this study. 45 patients were received a standard (150mg/day)micafungin treatment, and 27 patients were received a high dosage (200-300mg/day)micafungin treatment. Neutropenia status were similar between two groups (37.78% and 33.33%), so were other underlying risk factors. The mean duration of therapy were 15.27 days (Range: 7-47 days) in standard micafungin group, and 14.96 days (Range: 7-51 days) in high dosagemicafungin group. Drug related adverse events (AEs) occurred in 11.11% of patients received the standard regimen, and 14.81% of patients received the high dosage regimen (difference, 3.70%; 95% confidence interval [CI], -5.75% to 10.89%; statistically insignificant). The most common drug related AEs in the standard and high dosage treatment groups were liver dysfunction. Only 1 patient discontinued standard micafungin treatment, because liver function test value is 5 times greater than the upper limit of normal value. 86.67% of patients from standard treatment group, and 88.89% of patients from high dosage treatment group had favorable overall responses (difference, 2.22%; 95% CI, -4.94% to 8.64%; statistically insignificant).Conclusion: Both micafungin dosing treatments were effective, and well tolerated among hematologic patients with invasive fungal infection. Therefore, there hasn’t arisen any safety concern of high dosage(200-300mg/day) micafungin treatment.

scholarly journals Invasive Fungal Infections in Under-Five Diarrheal Children: Experience from an Urban Diarrheal Disease Hospital

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 94
Author(s):  
Nusrat Jahan Shaly ◽  
Mohammed Moshtaq Pervez ◽  
Sayeeda Huq ◽  
Dilruba Ahmed ◽  
Chowdhury Rafiqul Ahsan ◽  
...  
Keyword(s):  
Septic Shock ◽  
Early Diagnosis ◽  
Late Onset ◽  
Fungal Infections ◽  
Severe Acute Malnutrition ◽  
Fatal Outcome ◽  
Invasive Fungal Infections ◽  
Acute Malnutrition ◽  
Study Group ◽  
Co Morbidity

Invasive fungal infections (IFIs) are opportunistic, especially in immunocompromised and hospitalized patients. Children with IFIs are more vulnerable to a fatal outcome. For early diagnosis and treatment, knowledge of the spectrum and frequency of IFIs among children is prerequisite. In this prospective observational study, we enrolled 168 children of 2–59 months old of either sex from March 2018 to December 2019 admitted to the Dhaka hospital, icddr,b. Study participants with suspected IFIs were with or without severe acute malnutrition (SAM) along with sepsis/pneumonia and fulfilled any of the following criteria: (i) failure to respond to injectable antibiotics, (ii) development of a late-onset hospital-acquired infection, (iii) needed ICU care for >7 days, (iv) took steroids/antibiotics for >2 weeks before hospitalization, and (v) developed thrush after taking injectable antibiotics. The comparison group included non-SAM (weight-for-length Z score ≥ −2) children with diarrhea and fever <3 days in the absence of co-morbidity. We performed real-time PCR, ELISA, and blood culture for the detection of fungal pathogen. Study group children with SAM, positive ELISA and PCR considered to have a IFIs. In the study group, 15/138 (10.87%) children had IFIs. Among IFIs, invasive candidiasis, aspergillosis, histoplasmosis detected in 6 (4.53%), 11 (7.97%), and 1 (0.72%) children, respectively, and (3/15 [2.17%]) children had both candidiasis and aspergillosis. Children with IFIs more often encountered septic shock (26.7% vs. 4.9%; p = 0.013) and had a higher death rate (46.7% vs. 8.9%; p < 0.001) than those without IFIs. IFIs were independently associated with female sex (OR = 3.48; 95% CI = 1.05, 11.55; p = 0.042) after adjusting for potential confounders. Our findings thus implicate that, malnourished children with septic shock require targeted screening for the early diagnosis and prompt management of IFIs that may help to reduce IFIs related deaths.

scholarly journals Liquid biopsy for infectious diseases: sequencing of cell-free plasma to detect pathogen DNA in patients with invasive fungal disease

2018 ◽  
Vol 92 (3) ◽  
pp. 210-213 ◽  
Author(s):  
David K. Hong ◽  
Timothy A. Blauwkamp ◽  
Mickey Kertesz ◽  
Sivan Bercovici ◽  
Cynthia Truong ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Liquid Biopsy ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Pathogen Dna ◽  
Free Plasma

scholarly journals Epidemiology and Antifungal Susceptibility Patterns of Invasive Fungal Infections (IFIs) in India: A Prospective Observational Study

2021 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
Yubhisha Dabas ◽  
Immaculata Xess ◽  
Mragnayani Pandey ◽  
Jaweed Ahmed ◽  
Janya Sachdev ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Observational Study ◽  
Odds Ratio ◽  
Prospective Observational Study ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Invasive Fungal Infections ◽  
European Organization ◽  
Icu Admission ◽  
Coronary Arterial Disease

The epidemiology of invasive fungal infections (IFI) is ever evolving. The aim of the present study was to analyze the clinical, microbiological, susceptibility, and outcome data of IFI in Indian patients to identify determinants of infection and 30-day mortality. Proven and probable/putative IFI (defined according to modified European Organization for Research and Treatment of Cancer/Mycoses Study Group and AspICU criteria) from April 2017 to December 2018 were evaluated in a prospective observational study. All recruited patients were antifungal naïve (n = 3300). There were 253 episodes of IFI (7.6%) with 134 (52.9%) proven and 119 (47%) probable/putative infections. There were four major clusters of infection: invasive candidiasis (IC) (n = 53, 20.9%), cryptococcosis (n = 34, 13.4%), invasive aspergillosis (IA) (n = 103, 40.7%), and mucormycosis (n = 62, 24.5%). The significant risk factors were high particulate efficiency air (HEPA) room admission, ICU admission, prolonged exposure to corticosteroids, diabetes mellitus, chronic liver disease (CLD), acquired immunodeficiency syndrome (AIDS), coronary arterial disease (CAD), trauma, and multiorgan involvement (p < 0.5; odds ratio: >1). The all-cause 30-day mortality was 43.4% (n = 110). It varied by fungal group: 52.8% (28/53) in IC, 58.8% (20/34) in cryptococcosis, 39.8% (41/103) in IA, and 33.9% (21/62) in mucormycosis. HEPA room, ICU admission for IC; HEPA rooms, diabetes mellitus for cryptococcosis; hematological malignancies, chronic kidney disease (CKD), sepsis, galactomannan antigen index value ≥1 for IA and nodules; and ground glass opacities on radiology for mucormycosis were significant predictors of death (odds ratio >1). High minimum inhibitory concentration (MIC) values for azoles were observed in C. albicans, C. parapsilosis, C. glabrata, A. fumigatus, A. flavus, R. arrhizus, R. microsporus, and M. circinelloides. For echinocandin, high MIC values were seen in C. tropicalis, C. guillermondii, C. glabrata, and A. fumigatus. This study highlights the shift in epidemiology and also raises concern of high MICs to azoles among our isolates. It warrants regular surveillance, which can provide the local clinically correlated microbiological data to clinicians and which might aid in guiding patient treatment.

scholarly journals Liquid biopsy for infectious diseases: Sequencing of cell-free plasma to detect pathogen DNA in patients with invasive fungal disease

2018 ◽  
Author(s):  
David K. Hong ◽  
Timothy A. Blauwkamp ◽  
Mickey Kertesz ◽  
Sivan Bercovici ◽  
Cynthia Truong ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Invasive Fungal Disease ◽  
Invasive Fungal Infections ◽  
High Morbidity ◽  
Non Invasive ◽  
Treatment Information ◽  
Life Threatening ◽  
Pathogen Dna ◽  
Microbiologic Diagnosis ◽  
Free Plasma

AbstractDiagnosis of life-threatening deep-seated infections currently requires invasive sampling of the infected tissue to provide a microbiologic diagnosis. These procedures can lead to high morbidity in patients and add to healthcare costs. Here we describe a novel next-generation sequencing assay that was used to detect pathogen-derived cell-free DNA in peripheral blood of patients with biopsy-proven invasive fungal infections. The non-invasive nature of this approach could provide rapid, actionable treatment information for invasive fungal infections when a biopsy is not possible.

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