Host factors for invasive fungal infection among patients with haematological malignancies: a case control study

M. Hoenigl*, T. Valentin, A. Strohmeier, V. Strenger, H. Salzer, C. Koidl, A. Valentin, K. Seeber, I. Zollner-Schwetz, A. Woelfler, W. Buzina, R. Krause

Author address: 

(Graz, AT)

Abstract: 

Objectives: Host factors defined by revised EORTC/MSG criteria describe predisposing conditions of the individual for development of invasive fungal infection (IFI). Fulfilment of these factors is required for establishing diagnosis of possible or probable IFI which account for the majority of IFI in recent epidemiologic studies among patients with hematological malignancies. Host factors have, therefore, a major impact on IFI epidemiology when current criteria for defining IFI applied. This study evaluates host factors among patients with hematological malignancies. Methods: This is a single center study. Fifty-eight patients with haematological malignancies who developed probable (n = 38) or proven (n = 20) IFI within a 5-year-period were retrospectively evaluated regarding host and risk factors for IFI such as neutropenia, use of corticosteroids or t-cell suppressants, stem cell transplantation (SCT), underlying diseases and demographic factors. Aspergillus spp. was the leading causative pathogen (n = 36), followed by Candida spp. (n = 12). Results obtained were compared to results of patients with hematological malignancies who did not develop IFI (120 patients who received systemic antifungal therapy and 197 patients who did not, all data collected in 2010). Patients with possible IFI were excluded from the study. Results: Prolonged neutropenia, recent allogeneic SCT, steroid therapy and t-cell suppressive therapy were significantly associated with development of IFI and/or invasive mould infection (IMI) in our patient collective. In the case of prolonged corticosteroid use a cut-off of 14 days was highly significantly, while the currently proposed cutoff (21 days) was significantly associated with development of IFI. Results are depicted in Table 1.Conclusion: We conclude that host factors according to revised EORTC/MSG criteria were significantly associated with development of IFI/IMI in our collective of patients. In case of previous allogeneic
2012

abstract No: 

P809

Full conference title: 

22nd European Congress of Clinical Microbiology and Infectious Diseases
    • ECCMID 22nd (2012)