Background: Z is an important life-threatening mycosis in severely immunocompromissed cancer patients (pts) with a complex epidemiology. Although treatments options such as lipid amphotericin B formulations and compassionate use of posaconazole (POS) have become available over the past decade, optimal management strategies for patients with Z remain poorly defined. Methods: The medical records of pts with Z in our institution were reviewed from 1/1989-4/2006. We analyzed incidence, clinical and microbiological characteristics, antifungal therapy and predictors of outcome in 95 eligible cases. Results: Nearly all pts (93/95, 98%) had haematological malignancies, including 38 (40%) HSCT recipients. Z incidence began to rise after 1994 and increased significantly after 2002 (0.87 and 14.2 cases /104 inpatient days respectively, P 11 (OR 4.9, P = 0.02), and mismatched or unrelated HSCT (OR 7.6, P = 0.04) were independent predictors of poor outcome. Conclusions: Control of underlying predisposing factors offers the best chances for improved outcome of Z in cancer pts. POS appears to be a promising therapy for Z but requires further prospective evaluation.
Full conference title:
46th Interscience Conference on Antimicrobial Agents and Chemotherapy
- ICAAC 46th