Epidemiology and mortality of fungaemia in cancer patients – a clinical cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031)

Ref ID: 17717

Author:

O.A. Cornely*, B. Gachot, H. Akan, M. Bassetti, O. Uzun, C. Kibbler,
O. Marchetti, J. Bille, P. de Burghgraeve, L. Pylkkanen, L. Ameye,
M. Paesmans, J. Donnelly on behalf of the Infectious Diseases
Group (IDG of the European Organization for Resea

Author address:

(EORTC 65031))

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

Background: To characterize the epidemiology and mortality of
fungaemia among European cancer patients
Methods: Prospective cohort study including 145 030 patients (pts)
with cancer in 13 EORTC centres in eight European countries. Data
were analyzed for incidence of fungaemia, demographics, clinical
characteristics and outcome.
Results: Fungaemia occurred in 333 (2.3&; 95% CI, 2.1-2.6) pts,
ranging from 1.5& in pts with solid tumors (ST) to 14.6& in recipients
of haematopoietic stem cell transplantation for haematological
malignancy (HM). In 297 pts with evaluable clinical data median age
was 56 (range 17-88), 144 (48%) were female, 165 (56%) had ST, and
140 (47%) had HM.
At time of fungaemia, remission of underlying cancer had been
achieved in 29 (18%) of ST pts and in 20 (14%) of HM pts.
Treatment in the prior 30 days encompassed chemotherapy in 142
(48%), radiotherapy in 22 (7%), immune suppressants in 88 (39%),
antibiotics in 255 (86%), antifungals in 89 (30%), and major surgery
in 69 (23%) pts. At time of fungaemia, 110 (38%) pts were
neutropenic, 275(93%) were febrile, and deep-organ involvement was
documented in 83 (31%) pts. Central venous catheters (CVC) were
used in 238 (80%), peripheral cannulas in 29 (10%), and both in 13
(4%) pts. The CVC was removed in 167 (67%) cases after a median
of 3 day (min-max: 0-112).
Candidaemia was documented in 267 (90%) pts, while 30 (10%) had
fungaemia due to other fungi. Candidaemia was caused by C. albicans
in 128 (48%) and by other Candida species in 145 (54%) pts (six had >1
isolates).
The survival rate after 4 weeks was 64% (95% CI, 59-70%) and
decreased to 45% (95% CI, 39-51%) at 12 weeks. According to the
investigators fungaemia was the sole cause of death within 12 weeks in
seven (5%) and had contributed to death in 62 (44%) pts. Survival was
not significantly different between candidaemia caused by C. albicans
vs. other Candida species.
Conclusions: Fungaemia was a rare complication in cancer patients
from EORTC IDG centres, but was associated with or contributed to
substantial mortality. Candida albicans accounted for fewer than half
the candidaemia cases. No difference in mortality was found comparing
infections due to C. albicans vs. other Candida spp.

Abstract Number: NULL

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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