de León-Borrás Rafael, DelPilar-Morales Esteban, Rivera-Pérez Nicole, Pallens-Feliciano Mara, Tirado-Gómez Maribel, González-Sepúlveda Lorena, Bertrán-Pasarell Jorge
Division of Infectious Diseases, Department of Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
Division of Hematology Oncology, Department of Medicine, University of Puerto Rico School of Medicine, San Juan Puerto Rico.
Bol Asoc Med P R. 2017;109(1):43-48.
Fungal infections represent a serious complication for immunosuppressed patients resulting in an increased morbidity and mortality. A non-concurrent prospective study was performed to evaluate the factors associated to invasive fungal infection (IFI) in patients with hematological malignancies admitted to the University Hospital in San Juan, Puerto Rico from January 1, 2011 through June 15, 2014. The medical records of 84 patients were evaluated. Fifty-nine patients with IFI and twenty-five without IFI. The majority were men between 35 to 55 years old. The main hematological diagnosis was acute myelogenous leukemia (AML) followed by acute lymphoblastic leukemia (ALL). Seventy-percent developed IFI. The most common fungi were followed by non-albicans species, Fusarium and, Aspergillus species, respectively. About 63% of the patients with AML and 81% without AML had IFI. Those who received steroids were more likely to develop IFI. After adjusting for AML and age, the odds of IFI among patients using steroids were 3.33 higher than those not using steroids. Patients who were exposed to different antifungal medication had 72% lower odds to develop IFI.
真菌感染是免疫抑制患者的严重并发症,会导致发病率和死亡率上升。我们进行了一项非同期前瞻性研究,以评估2011年1月1日至2014年6月15日期间入住波多黎各圣胡安大学医院的血液系统恶性肿瘤患者中与侵袭性真菌感染(IFI)相关的因素。我们评估了84例患者的病历。其中59例患有IFI,25例未患IFI。大多数患者为35至55岁的男性。主要血液学诊断为急性髓性白血病(AML),其次是急性淋巴细胞白血病(ALL)。70%的患者发生了IFI。最常见的真菌依次为非白色念珠菌、镰刀菌和曲霉菌。约63%的AML患者和81%的非AML患者发生了IFI。接受类固醇治疗的患者更易发生IFI。在对AML和年龄进行校正后,使用类固醇的患者发生IFI的几率比未使用类固醇的患者高3.33倍。接受不同抗真菌药物治疗的患者发生IFI的几率降低了72%。