Breakthrough (BT) Invasive Aspergillosis (IA) in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) Patients Treated with Caspofungin (C).

A. MADUREIRA 1, A. BERGERON 1, C. LACROIX 1, M. ROBIN 1, R. PEFFAULT DE LATOUR 1, J. LAPALU 1, G. SOCIE 1, M. GHANNOUM 2, P. RIBAUD1;

Author address: 

1Hosp. Saint-Louis, Paris, France, 2Univ. Hosp. of Cleveland, Cleveland, OH.

Abstract: 

Background: C is used at our center for empirical treatment of fever. Method: We reviewed the clinical records of the 156 SCT patients who received empirical C between 01/2004 and 04/2007 and developed BT IA (occurring > 6 days (d) after C initiation). Results: There were 9 BT IA (6%). The table shows patient and IA characteristics, and susceptibility testing of the isolates. Abbreviations: CR, complete response; Stab, stabilization; Fail, failure; AB, Amphotericin B; A, Anidulafungin; M, Micafungin; V, Voriconazole; NA, not available; * day post-transplant; **MIC, minimal inhibitory concentration (AB & V) & MEC, minimal effective concentration (echinocandins). Conclusion: It is unknown if the high incidence of BT IA in patients receiving empirical C (with high MECs to C for 2/4 isolates) represents a clinically meaningful limitation of C or if it reflects the poor immune status of the SCT population.
2007

abstract No: 

M-1166

Full conference title: 

47th Interscience Conference on Antimicrobial agents and Chemotherapy
    • ICAAC 47th