Servicio de Hematología, Hospital Joan XXIII, IISPV, Tarragona, Spain.
Enferm Infecc Microbiol Clin. 2011 Apr;29(4):263-8. doi: 10.1016/j.eimc.2010.09.008. Epub 2011 Feb 16.
To investigate mortality risk factors in patients with zygomycosis.
Retrospective case history review of patients diagnosed with proven zygomicosis in 17 centres in Spain. We compared demographics and risk factors in patients who survived, and in those who died.
We identified twenty-five patients with proven zygomycosis. The primary site of infection was rhino-orbito-cerebral (28%) and disseminated (20%) or cutaneous/soft infections (20%) of the patients. Eleven patients (44%) received preemptive or empirical antifungal treatment; of these patients, 4 received liposomal amphotericin B, 1 received amphotericin B lipid complex, and 6 received other antifungals. The overall mortality rate was 72%. In the univariate analysis factors associated with an increased risk of death were the presence of a haematological malignancy (P=.03), neutropenia (P=.03) and monocytopenia (P=.008).
Our study supports previous research that has documented a high mortality rate among patients with invasive zygomycosis, especially among those with an underlying haematological malignancy, and the need for a rapid initiation of an effective antifungal treatment.
研究接合菌病患者的死亡风险因素。
回顾性分析了在西班牙 17 个中心确诊为接合菌病的患者的病历。我们比较了存活患者和死亡患者的人口统计学和风险因素。
我们确定了 25 例确诊为接合菌病的患者。感染的主要部位是鼻-眶-脑（28%）和播散性（20%）或皮肤/软组织感染（20%）。11 例患者（44%）接受了预防性或经验性抗真菌治疗；其中 4 例接受了脂质体两性霉素 B，1 例接受了两性霉素 B 脂质复合物，6 例接受了其他抗真菌药物。总的死亡率为 72%。单因素分析显示，血液恶性肿瘤（P=.03）、中性粒细胞减少（P=.03）和单核细胞减少（P=.008）与死亡风险增加有关。
我们的研究支持了先前的研究，即侵袭性接合菌病患者的死亡率很高，尤其是患有血液恶性肿瘤的患者，并且需要迅速开始有效的抗真菌治疗。
