Registry for systemic mycosis in Germany (ReSyMe) – role of EORTC/MSG diagnostic criteria in clinical practice

Ref ID: 17748

Author:

M. Ruhnke*, A. Mikojalewska, A. Groll,

Author address:

O.A. Cornely, C. Lass-Flörl on
behalf of the ReSyMe working group

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

Introduction: The Registry of Systemic Mycoses (ReSyMe) was
developed as a multi-center prospective study by the German-speaking
Mycological Society (DMykG) and the Paul-Ehrlich-Society (PEG) to
study the current use of antifungal therapy in Germany with regard to
the EORTC/MSG diagnostic criteria (version from 2002).
Material and methods: In this prospective, non-comparative study,
543 patients treated with systemic antifungal therapy were documented
within a 1 year period (5/2008-4/2009) via an online-documentation
system. Primary questions of the registry addressed: (i) analyzing the
current epidemiology for invasive fungal infections in Germany. (ii)
analyzing the proposed definitions for invasive fungal diseases
(possible, probably, and proven disease) on the bedside in everyday
practice (EORTC/MSG). (iii) analyzing antifungal therapy in the ICU,
as compared to non-ICU patients.
Results: Fifteen clinical units from 10 hospitals participated in the
study. In total, 543 patients (3-101 patients per clinical unit) were
documented, with a median age of 60 years (1-95 years). 61.5% were
male (51.8-70%), 38.5% were female (48.2-30.4%). Two hundred and
forty-two patients were treated at the ICU (44%) and 56% (n = 301)
were non-ICU patients. Among the ICU patients, 67.8% underwent a
surgical procedure (SD), 16.2% suffered from an internal disease (MD),
12.8% from haematological cancer (HC), and 3.3% had a solid tumor.
According to the main underlying disease, all patients were divided into
four groups: the largest group represented patients with a
haematological malignancy (55.9%), followed by patients with
surgical procedure (30.7%), internal disease (8.4%), and solid tumors
(5%).
Patients with MD (mean 70 years) and SD (mean 64 years) were older
as compared to the other two groups. Ninety-eight percent (SD) and
85% (MD) of patients were treated in an ICU as compared to 10% with
HC. According to the EORTC criteria for the definition of an invasive
fungal disease (IFD), antifungal therapy could be applied in ICU
patients (SD) in 21% for proven IFD, 15% probable, and 36% possible
IFD. In 21% treatment was given as empirical therapy in ICU patients
as compared to 35% in non-ICU patients. The lungs (61%) were the
most common site of IFD, 18% had a disseminated infection. The
majority of patients received first-line treatment with azoles (33%
fluconazole, 29% voriconazole). Echinocandins were given in 10% of
patients. EORTC-MSG criteria could be applied in 72% of ICU
patients, but in only 65% of non-ICU patients.

Abstract Number: NULL

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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