Changing Spectrum of Invasive Fungaemia in a Large Haemato-Oncology Stem Cell Transplant Unit.

B. SIROHI, R. POWLES, U.B.G. RILEY

Author address: 

Royal Marsden NHS Trust, Sutton, United Kingdom

Abstract: 

Background As transplantation practices have evolved to include systemic antifungal prophylaxis, spectrum of invasive candidiasis has changed. Candida albicans is the most frequently isolated Candida species although the proportion of infections caused by non-albicans species is increasing. All patients in leukaemia & myeloma unit at the Royal Marsden Hospital receive topical anti-fungal prophylaxis with non-absorbable polyenes. Only matched-unrelated stem cell transplant patients receive prophylaxis with fluconazole 200mg orally once a day. Method The prospectively maintained microbiology database was investigated to identify haematology patients with fungaemia during the period January 1997 and March 2002. Results We identified with 17 patients with fungaemia. All patients were neutropenic at the time of isolation and the majority of patients had multiple isolates. Candidaemia contributed to death in 7 patients. There were 3 patients with Candida albicans, 13 patients with non-albicans yeast and 1 patient with Fusarium solani. 4 patients had proven line-associated candidaemia; all non-albicans. There has been an increase in the impact of candidaemia in the unit. From 1997 to July 2000, fungal blood isolates contributed 2.6% (17/607) to the total of blood culture isolates from haematology patients in the unit (including multiple isolates). These were in 7 patients all with different fungal species. From August 2000 to April 2002 they contribute 12.1% (28/231; P
2002

abstract No: 

M-897

Full conference title: 

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    • ICAAC 42nd