scholarly journals Epidemiological evaluation of patients submitted to the galactomannan test with suspected invasive aspergillosis

2021 ◽  
Vol 50 (2) ◽  
pp. 107-119
Author(s):  
Daiane De Oliveira Cunha ◽  
Jacqueline Andreia Bernardes Leão Cordeiro ◽  
Hellen Da Silva Cintra de Paula ◽  
Fabio Silvestre Ataides ◽  
Cesar Sam Tiago Vilanova-Costa ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Invasive Aspergillosis ◽  
Invasive Pulmonary Aspergillosis ◽  
Positive Culture ◽  
Elisa Test ◽  
P Value ◽  
European Organization ◽  
Early Therapy ◽  
Risk Of Death ◽  
Epidemiological Characteristics

Invasive aspergillosis (IA) increases dramatically when there is potential risk in many patient groups, in particular with hematological malignancies. The purpose of the study was to trace the epidemiological profile of patients who underwent galactomannan test by ELISA with suspected IA and to determine the factors that contribute to the development of the disease. We evaluated 264 patients who underwent galactomannan test with suspected IA from 2013 to 2015.The clinical-epidemiological characteristics were determined using descriptive statistics. The variables were evaluated using the chi-square test (χ2) and the G-test, with p-value considered significant below 0.05. According to the classification for IA by the European Organization for Research and Treatment of Cancer, the disease was considered proven in 7.3%, defined by positive culture for the fungus, 6.4% as probable through detection of galactomannan and the presence of pulmonary infiltrates and 5.1% as possible by radiological alterations suggestive of IA and negative galactomannan test. The mortality rate was 31.6% of all patients and 61.3% for proven / probable / possible IA indicating that the disease was significantly associated with the risk of death. According to these result indications and considering the high mortality rate caused by the development of IA, as well as the fact that early therapy promotes significant improvement in the patients’ prognosis, we conclude that the detection of galactomannan may be considered an effective method to aid the identification of IA.  KEY WORDS: Invasive pulmonary aspergillosis; neutropenia; enzyme-liked immunosorbent assay; ELISA test searching for Aspergillus; galactomannan.

scholarly journals Clinical and Epidemiological Characteristics of Carbapenem-resistant Klebsiella Pneumoniae Infections in a Tertiary Hospital in China

2021 ◽  
Author(s):  
Zhiwen Cui ◽  
Lirui Wang ◽  
Wei Chang ◽  
Minghui Li ◽  
Yuexia Li ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Sofa Score ◽  
Positive Culture ◽  
Bloodstream Infections ◽  
Polymyxin B ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Carbapenem Resistant ◽  
Epidemiological Characteristics ◽  
Antimicrobial Regimen

Abstract Background: The infections due to carbapenem-resistant Klebsiella pneumonia (CR-KP) have become an important problem and they are associated with a high mortality rate. The aim of the study is to evaluate the clinical and epidemiological characteristics of CR-KP.Methods: A retrospective cohort study has been made on all patients presenting with CR-KP infections. 615 patients with CR-KP humor infections diagnosed between January 2018 and December 2019 were identified. 135 patients who did not meet the requirements were excluded, and the remaining 480 patients were enrolled in the study. We have evaluated the mortality in 30 days from the first positive culture. Clinical characteristics, antimicrobial regimens, and outcomes of patients have been analyzed.Results: The CR-KP infections overall mortality was 37.3%, and bloodstream infections mortality was 66.2%. Survival analysis revealed that there were statistically significant differences between bloodstream infection and pulmonary and drainage fluid infection. The gender, wards, and endotracheal intubation or tracheotomy before positive culture did not differ between the non-survivor and survivor groups. Logistics regression analysis showed that hemopathy, age (>60 years), solid tumors, diabetes, septic shock, acute kidney injury and stroke were independent predictors associated with the 30-day mortality. Multivariate linear regression was performed in APACHE II score, SOFA score, lymphocyte absolute value (LYM) and survival time. Survival time was negatively correlated with APACHE II score and SOFA score, while positively correlated with LYM. In addition, ROC curves were also drawn for APACHE II score, SOFA score and LYM, with AUC of 0.825, 0.876 and 0.797, respectively. Finally, we investigated different antimicrobial regimens for CR-KP infections. Chi-square test showed that antimicrobial regimen combined carbapenems, tigecycline with polymyxin B was superior the one combined carbapenems with polymyxin B, and the difference had statistically significant. But there was not statistically significant difference between carbapenems plus tigecycline and carbapenems plus polymyxin B, and it seemed that polymyxin B and tigecycline have synergistic effect. Ceftazidime avibactam-based antimicrobial regimens also had no advantage over other therapeutic regimens.Conclusions: Our study confirmed there is a high mortality rate in CR-KP infections, especially in the bloodstream infections. The outcome is greatly influenced by the patients’ clinical conditions. Antimicrobial regimen combined carbapenems, tigecycline with polymyxin B might be a better choice.

EFEKTIFITAS KONSELING LAKTASI PADA IBU HAMIL TRIMESTER III TERHADAP PELAKSANAAN MENYUSUI

2019 ◽  
Vol 11 (1) ◽  
pp. 41-50
Author(s):  
Heni Purwaningsih ◽  
Umi Aniroh ◽  
Eko Mardiyaningsih
Keyword(s):  
Mortality Rate ◽  
Pregnant Women ◽  
Body Position ◽  
Development Program ◽  
Optimal Growth ◽  
Infant Mortality Rate ◽  
P Value ◽  
Time Data ◽  
Emotional Bonding ◽  
Post Test

Program pembangunan kesehatan di Indonesia masih berfokus pada upaya peningkatan derajat kesehatan ibu dan anak terutama pada masa prenatal. Hal ini disebabkan masih tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB). ASI yang diberikan sejak usia dini dan dilanjutkan dengan ASI eksklusif selama 6 bulan dapat menurunkan angka kesakitan dan angka kematian bayi serta meningkatkan tumbuh kembang bayi secara optimal.  Penelitian ini bertujuan untuk mengetahui efektifitas pemberian konseling laktasi terhadap pelaksanaan menyusui pada ibu hamil trimester III. Desain penelitian menggunakan quasi eksperimen dengan rancangan One Group Pre-test dan  Post-test Desain. Populasi dalam penelitian ini adalah ibu hamil trimester III dan sampel yang diambil adalah 18 ibu hamil. Alat penggumpulan data menggunakan lembar observasi BREAST (body position, respons, emotional bonding, anatomy dan sucking time). Analisis data menggunakan wilcoxon.Hasil penelitian didapatkan pelaksanaan menyusui sebelum dilakukan konseling laktasi dalam kategori kurang (72,2%) sedangkan pelaksanaan menyusui setelah dilakukan konseling laktasi (77,8%) dalam kategori baik. Konseling laktasi efektif dilakukan untuk meningkatkan pelaksanaan menyusui denganp-value 0,003 (p<0,005).Konseling laktasi seharusnya diberikan pada masa prenatal sehingga pada saat postpartum, ibu sudah mampu memberikan asi secara maksimal. Pendampingan terhadap ibu hamil juga berperan dalam pelaksanaan pemberian ASI.   Kata kunci : Konseling laktasi, ASI, pelaksanaan menyusui   THE EFFECTIVENESS OF LACTATION COUNSELING IN THE 3rd TRIMESTER PREGNANT WOMEN ON BREASTFEEDING IMPLEMENTATION   ABSTRACT Indonesia's health development program still focuses on improving mother and child health, especially at the prenatal stage. It is due to the high maternal mortality rate (MMR) and Infant Mortality Rate (IMR). Breastmilk given from an early age and continued with exclusive breastfeeding for six months can reduce infants morbidity and mortality rate and increase their optimal growth. The purpose is to investigate the effectiveness of lactation counseling to the implementation of breastfeeding in third-trimester. The study design used quasi experiments with one group pre-test and post-test. Population was the 3rd-trimester pregnant mothers, and the samples were 18 mothers. The data collection tool used BREAST observation sheets (body position, response, emotional bonding, anatomy and sucking time). Data analysis used Wilcoxon. The result of the research shows that breastfeeding before lactation counseling is in less category (72,2%) while breastfeeding after lactation counseling (77,8%) is in a goodcategory. Effective lactation counseling is performed to improve the implementation of breastfeeding with p-value 0.003 (p <0.005). Lactation counseling should be given during the prenatal period so that at the time of postpartum, the mother has been able to give breastmilk maximally. Mentoring for pregnant women also plays a role in the implementation of breastfeeding Keywords: lactation counseling, breast milk, breastfeeding implementation

Epidemiological Characteristics of Meningococcal Infection in Moscow

2020 ◽  
Vol 19 (2) ◽  
pp. 56-62
Author(s):  
M. I. Gritsay ◽  
M. A. Koroleva ◽  
N. N. Fomkina ◽  
I. S. Koroleva
Keyword(s):  
Young Adults ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Meningococcal Disease ◽  
Invasive Meningococcal Disease ◽  
Meningococcal Infection ◽  
Epidemic Process ◽  
Epidemiological Features ◽  
Teenagers And Young Adults ◽  
Epidemiological Characteristics

Aims. The purpose of this study was to identify current epidemiological features of meningococcal infection in Moscow.Materials and methods. Cases of invasive meningococcal disease in Moscow from 2014 to 2018 and the biomaterial from patients with an invasive meningococcal disease were analyzed.Results. The features of the epidemic process of meningococcal disease in Moscow were revealed: increasing in the incidence rate involving teenagers and young adults into the epidemic process; meningococcal strains of serogroups W and A increased in the etiology of the invasive meningococcal disease; high mortality rate.Conclusions. It seems reasonable to recommend vaccination against meningococcal disease by including adolescents, young adults and persons over 65 years old.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN BBLR DI RUMAH SAKIT UMUM DAERAH PALEMBANG BARI TAHUN 2013

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Juliana Widyastuti Wahyuningsih Juliana Widyastuti Wahyuningsih
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Random Sampling ◽  
Maternal Age ◽  
Univariate Analysis ◽  
Infant Mortality Rate ◽  
Survey Method ◽  
P Value ◽  
Chi Square

ABSTRACT   Low birth weight (LBW) infants with birth weight is less than 2500 grams, regardless of gestational age. Statistically showed 90 % incidence of LBW obtained in developing countries with a mortality rate 35 times higher tinggi.Di South Sumatra Province Infant Mortality Rate ( IMR ) is 29 per 1,000 live births. In Palembang BARI hospitals incidence of LBW in 2013 amounted to 317 cases . The purpose of this study is to determine is there a relationship between the factors of age, education, and parity with the incidence of Low Birth Weight in Palembang BARI hospitals in 2013. This study used survey method crosss sectional analytic approach. The study population was all women who gave birth and was admitted to hospital obstetrics Palembang BARI installations in 2013 amounted to 901. This research was conducted in February 2014. Samples were taken with a random sampling method sistematic. Analyze data using statistical test Chi - Square. Results of univariate analysis of this study showed that 193 (69.4 %) of the respondents had low birth weight, and 85 (30.6 %) respondents had BBLN. 63 (22.7 %) of respondents with a high risk of maternal age and 215 (77.3 %) of respondents with a low risk of maternal age. 157 (56.5 %) respondents with low education mothers and 121 (43.5 %) of respondents with higher education mothers. 48 (17.3 %) respondents with high parity mothers and 230 (82.7 %) respondents with low parity mothers. So the bivariate analysis showed no significant association between maternal age with the incidence of LBW with P value = 0.035, no significant association between education and the incidence of LBW with P value = 0.006, and no significant relationship between the incidence of low birth weight with parity P value = 0.041. It is recommended for health care workers (midwives) hospital in order to be used as material information regarding the occurrence of LBW and as an input as well as the evaluation of success in good health or when needed to do counseling and care of LBW, especially to mothers who give birth to low birth weight baby.   ABSTRAK Berat badan lahir rendah (BBLR) adalah bayi dengan berat lahir kurang dari 2500 gram tanpa memandang masa gestasi. Secara statistik menunjukkan 90% kejadian BBLR didapatkan di negara berkembang dengan angka kematiannya 35 kali lebih tinggi.Di Propinsi Sumatera Selatan Angka Kematian Bayi (AKB) sebesar 29 per 1.000 kelahiran hidup. Di RSUD Palembang BARI Tahun 2013 angka kejadian BBLR berjumlah 317 kasus. Tujuan Penelitian ini adalah untuk mengetahui adakah hubungan antara faktor umur, pendidikan, dan paritas dengan kejadian Berat Badan Lahir Rendah di RSUD Palembang BARI Tahun 2013. Penelitian ini menggunakan metode survey analitik dengan pendekatan crosss sectional. Populasi penelitian ini adalah semua ibu yang melahirkan dan dirawat inap di instalasi kebidanan RSUD Palembang BARI Tahun 2013 berjumlah 901. Penelitian ini dilakukan pada bulan Februari 2014. Sampel penelitian diambil dengan metode sistematic random sampling. Analisa data menggunakan uji statistik Chi – Square. Hasil penelitian analisis univariat ini menunjukkan bahwa 193 (69,4%) responden mengalami BBLR, dan 85 (30,6%) responden mengalami BBLN. 63 (22,7%) responden dengan umur ibu resiko tinggi dan 215 (77,3%) responden dengan umur ibu resiko rendah. 157 (56,5%) responden dengan ibu pendidikan rendah dan 121 (43,5%) responden dengan ibu pendidikan tinggi. 48 (17,3%) reponden dengan ibu paritas tinggi dan 230 (82,7%) responden dengan ibu paritas rendah. Sehingga analisa bivariat menunjukkan ada hubungan yang bermakna antara umur ibu dengan kejadian BBLR dengan P value = 0,035, ada hubungan yang bermakna antara pendidikan dengan kejadian BBLR dengan P value = 0,006 dan ada hubungan yang bermakna antara paritas dengan kejadian BBLR dengan P value = 0,041. Disarankan bagi petugas kesehatan (bidan) rumah sakit agar dapat dijadikan sebagai bahan informasi mengenai terjadinya BBLR dan sebagai bahan masukan serta evaluasi keberhasilan dalam pelayanan kesehatan yang baik atau bila perlu dilakukannya penyuluhan serta asuhan  tentang BBLR khususnya kepada ibu yang melahirkan Bayi dengan BBLR.  

Clinical Outcomes of Incidental Venous Thromboembolism in Cancer and Noncancer Patients: The SWIss Venous ThromboEmbolism Registry (SWIVTER)

2020 ◽  
Author(s):  
David Spirk ◽  
Tim Sebastian ◽  
Stefano Barco ◽  
Martin Banyai ◽  
Jürg H. Beer ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Mortality Rate ◽  
Recurrence Rate ◽  
Anticoagulation Therapy ◽  
Early Mortality ◽  
Recurrence Rates ◽  
Patients With Cancer ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Baseline Characteristics

Abstract Objective In patients with cancer-associated venous thromboembolism (VTE), the risk of recurrence is similar after incidental and symptomatic events. It is unknown whether the same applies to incidental VTE not associated with cancer. Methods and Results We compared baseline characteristics, anticoagulation therapy, all-cause mortality, and VTE recurrence rates at 90 days between patients with incidental (n = 131; 52% without cancer) and symptomatic (n = 1,931) VTE included in the SWIss Venous ThromboEmbolism Registry (SWIVTER). After incidental VTE, 114 (87%) patients received anticoagulation therapy for at least 3 months. The mortality rate was 9.2% after incidental and 8.4% after symptomatic VTE for hazard ratio (HR) 1.10 (95% confidence interval [CI] 0.49–2.50). After adjustment for competing risk of death, recurrence rate was 3.1 versus 2.8%, respectively, for sub-HR 1.07 (95% CI 0.39–2.93). These results were consistent among cancer (mortality: 15.9% vs. 12.6%; HR 1.32, 95% CI 0.67–2.59; recurrence: 4.8% vs. 4.7%; HR 1.02, 95% CI 0.30–3.42) and noncancer patients (mortality: 2.9% vs. 2.1%; HR 1.37, 95% CI 0.33–5.73; recurrence: 1.5% vs. 2.3%; HR 0.63, 95% CI 0.09–4.58). Patients with incidental VTE who received anticoagulation therapy for at least 3 months had lower mortality (4% vs. 41%) and recurrence rate (1% vs. 18%) compared with those who did not. Conclusion In SWIVTER, more than half of incidental VTE events occurred in noncancer patients who often received anticoagulation therapy. Among noncancer patients, early mortality and recurrence rates were similar after incidental versus symptomatic VTE. Our findings suggest that anticoagulation therapy for incidental VTE may be beneficial regardless of the presence of cancer.

scholarly journals AB0393 PRE-EXISTING MORBIDITY AS A RISK FACTORS FOR MORTALITY IN IgA VASCULITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1224.3-1225
Author(s):  
J. Nossent ◽  
D. Preen ◽  
W. Raymond ◽  
H. Keen ◽  
C. Inderjeeth
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Mortality Rate ◽  
Data Collection ◽  
Premature Death ◽  
Iga Vasculitis ◽  
Risk Of Death ◽  
Increased Risk ◽  
Serious Infections ◽  
Western Australian

Background:IgA vasculitis is generally considered to be a self-limiting condition, but this is at odds with the increased mortality observed in adult patients with IgA vasculitis (1).Objectives:With sparse data on prognostic factors in IgAV, we investigated whether pre-existing conditions are risk factors for mortality in adult IgAV patients.Methods:Observational population-based cohort study using state-wide linked longitudinal health data for adults with IgAV (n=267) and matched controls (n=1080) between 1980-2015. Charlson comorbidity index (CCI) and serious infections (SI) were recorded over an extensive lookback period prior to diagnosis. Date and causes of death were extracted from the WA Death Registry. Mortality rate (deaths/1000 person-years) ratios (MRR) and time dependent survival analysis assessed the risk of death. Age and gender specific mortality rate data were obtained from the Australian Bureau of Statistics.Results:During 9.9 (±9.8) years lookback IgAV patients accrued higher CCI scores (2.60 vs1.50 p<0.001) and had higher risk of SI (OR 8.4, p<0.001), not fully explained by CCI scores. During 19 years follow-up, the risk of death in IgAV patients (n=137) was higher than in controls (n=397) (MRR 2.06, CI 1.70-2.50, p<0.01) and the general population (SMRR 5.64, CI 4.25, 7.53, p<0.001). Survival in IgAV was reduced at five (72.7 vs. 89.7 %) and twenty years (45.2% vs. 65.6 %) (both p<0.05). CCI (HR1.88, CI:1.25 - 2.73, p=0.001), renal failure (HR 1.48, CI: 1.04 - 2.22, p=0.03) and prior SI (HR 1.48, CI:1.01 – 2.16, p=0.04) were independent risk factors. Death from infections (5.8 vs 1.8%, p=0.02) was significantly more frequent in IgAV patients.Conclusion:Premorbid accrual of comorbidity is increased and predicts premature death in IgAV patients. However, comorbidity does not fully explain the increased risk of serious infections prior to diagnosis or the increased mortality due to infections in IgAV.References:[1]Villatoro-Villar M, Crowson CS, Warrington KJ, Makol A, Ytterberg SR, Koster MJ. Clinical Characteristics of Biopsy-Proven IgA Vasculitis in Children and Adults: A Retrospective Cohort Study. Mayo Clin Proc. 2019;94(9):1769-80.Acknowledgements:The authors would like to acknowledge the support of the Arthritis Foundation of WA and acknowledge the Western Australian Data Linkage Branch, the Western Australian Department of Health, and the data custodians of, the Hospital and Morbidity Data Collection, the Emergency Department Data Collection the WA Cancer Register and the WA Death Register for their assistance with the study.Disclosure of Interests:None declared

scholarly journals Dynamic monitor of CT scan within short interval in invasive pulmonary aspergillosis for nonneutropenic patients: a retrospective analysis in two centers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Chen ◽  
Yonghong Zhong ◽  
Na Li ◽  
Huijie Wang ◽  
Yanbin Tan ◽  
...  
Keyword(s):  
Ct Scan ◽  
Respiratory Diseases ◽  
Short Interval ◽  
Invasive Pulmonary Aspergillosis ◽  
Host Factors ◽  
Antifungal Treatment ◽  
Ct Scans ◽  
Pulmonary Aspergillosis ◽  
European Organization ◽  
Life Threatening

Abstract Background In nonneutropenic patients with underlying respiratory diseases (URD), invasive pulmonary aspergillosis (IPA) is a life-threatening disease. Yet establishing early diagnosis in those patients remains quite a challenge. Methods A retrospective series of nonneutropenic patients with probable or proven IPA were reviewed from January 2014 to May 2018 in Department of Respiratory Medicine of two Chinese hospitals. Those patients were suspected of IPA and underwent lung computed tomography (CT) scans twice within 5–21 days. The items required for IPA diagnosis were assessed by their host factors, mycological findings and CT scans according to the European Organization for Research and Treatment of Cancer (EORTC) and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) criteria (EORTC/MSG criteria). Results Together with the risk factors, mycological findings and nonspecific radiological signs on first CT, ten patients were suspected of IPA. With the appearance of cavities on second CT scan in the following days, all patients met the criteria of probable or possible IPA. Except one patient who refused antifungal treatment, nine patients received timely antifungal treatment and recovered well. One of the nine treated IPA cases was further confirmed by pathology, one was confirmed by biopsy. Conclusions Dynamic monitor of CT scan provided specific image evidences for IPA diagnosis. This novel finding might provide a noninvasive and efficient strategy in IPA diagnosis with URD.

scholarly journals Clinical characteristics and risk factors for mortality in COVID-19 inpatients in Birjand, Iran: a single-center retrospective study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ghodsiyeh Azarkar ◽  
Freshteh Osmani
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Protein Level ◽  
Clinical Characteristics ◽  
Single Center ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Survivor Group ◽  
Epidemiological Characteristics

Abstract Background The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment. Methods This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses. Results The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases. Conclusions Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.

The Plasmair Decontamination System Is Protective Against Invasive Aspergillosis in Neutropenic Patients

2016 ◽  
Vol 37 (7) ◽  
pp. 845-851 ◽  
Author(s):  
Marie-Paule Fernandez-Gerlinger ◽  
Anne-Sophie Jannot ◽  
Sophie Rigaudeau ◽  
Juliette Lambert ◽  
Odile Eloy ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Severe Infection ◽  
Hematologic Malignancies ◽  
Preventive Strategies ◽  
European Organization ◽  
Exact Test ◽  
Eortc Criteria ◽  
Neutropenic Patients ◽  
Chemotherapy Induced Neutropenia ◽  
The Impact

OBJECTIVEInvasive aspergillosis (IA) is a rare but severe infection caused by Aspergillus spp. that often develops in immunocompromised patients. Lethality remains high in this population. Therefore, preventive strategies are of key importance. The impact of a mobile air decontamination system (Plasmair, AirInSpace, Montigny-le-Bretonneux, France) on the incidence of IA in neutropenic patients was evaluated in this study.DESIGNRetrospective cohort studyMETHODSPatients with chemotherapy-induced neutropenia lasting 7 days or more were included over a 2-year period. Cases of IA were confirmed using the revised European Organization for Research and Treatment of Cancer (EORTC) criteria. We took advantage of a partial installation of Plasmair systems in the hematology intensive care unit during this period to compare patients treated in Plasmair-equipped versus non-equipped rooms. Patients were assigned to Plasmair-equipped or non-equipped rooms depending only on bed availability. Differences in IA incidence in both groups were compared using Fisher’s exact test, and a multivariate analysis was performed to take into account potential confounding factors.RESULTSData from 156 evaluable patients were available. Both groups were homogenous in terms of age, gender, hematological diagnosis, duration of neutropenia, and prophylaxis. A total of 11 cases of probable IA were diagnosed: 10 in patients in non-equipped rooms and only 1 patient in a Plasmair-equipped room. The odds of developing IA were much lower for patients hospitalized in Plasmair-equipped rooms than for patients in non-equipped rooms (P=.02; odds ratio [OR] =0.11; 95% confidence interval [CI], 0.00–0.84).CONCLUSIONIn this study, Plasmair demonstrated a major impact in reducing the incidence of IA in neutropenic patients with hematologic malignancies.Infect Control Hosp Epidemiol 2016;37:845–851

scholarly journals Invasive aspergillosis with disseminated skin ınvolvement in a patient with acute myeloid leukemia: a rare case

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Duygu Mert ◽  
Gülşen Iskender ◽  
Fazilet Duygu ◽  
Alparslan Merdin ◽  
Mehmet Sinan Dal ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Invasive Aspergillosis ◽  
Myeloid Leukemia ◽  
Rare Case ◽  
Invasive Pulmonary Aspergillosis ◽  
Skin Lesions ◽  
Immunocompromised Patients ◽  
Skin Involvement ◽  
Pulmonary Aspergillosis ◽  
Acute Myeloid

Invasive pulmonary aspergillosis is most commonly seen in immunocompromised patients. Besides, skin lesions may also develop due to invasive aspergillosis in those patients. A 49-year-old male patient was diagnosed with acute myeloid leukemia. The patient developed bullous and zosteriform lesions on the skin after the 21st day of hospitalization. The skin biopsy showed hyphae. Disseminated skin aspergillosis was diagnosed to the patient. Voricanazole treatment was initiated. The patient was discharged once the lesions started to disappear.

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