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法国重症监护病房侵袭性镰刀菌病的多中心回顾性研究。

Multicenter Retrospective Study of Invasive Fusariosis in Intensive Care Units, France.

出版信息

Emerg Infect Dis. 2024 Feb;30(2):215-24. doi: 10.3201/eid3002.231221.

Abstract

Invasive fusariosis can be life-threatening, especially in immunocompromised patients who require intensive care unit (ICU) admission. We conducted a multicenter retrospective study to describe clinical and biologic characteristics, patient outcomes, and factors associated with death and response to antifungal therapy. We identified 55 patients with invasive fusariosis from 16 ICUs in France during 2002----2020. The mortality rate was high (56%). Fusariosis-related pneumonia occurred in 76% of patients, often leading to acute respiratory failure. Factors associated with death included elevated sequential organ failure assessment score at ICU admission or history of allogeneic hematopoietic stem cell transplantation or hematologic malignancies. Neither voriconazole treatment nor disseminated fusariosis were strongly associated with response to therapy. Invasive fusariosis can lead to multiorgan failure and is associated with high mortality rates in ICUs. Clinicians should closely monitor ICU patients with a history of hematologic malignancies or stem cell transplantation because of higher risk for death.

摘要

侵袭性镰刀菌病可能危及生命,尤其是在需要入住重症监护病房(ICU)的免疫功能低下的患者中。我们进行了一项多中心回顾性研究,以描述临床和生物学特征、患者结局以及与死亡和抗真菌治疗反应相关的因素。我们从法国 16 个 ICU 中确定了 2002 年至 2020 年期间 55 名侵袭性镰刀菌病患者。死亡率很高(56%)。镰刀菌病相关肺炎发生在 76%的患者中,常导致急性呼吸衰竭。与死亡相关的因素包括 ICU 入院时序贯器官衰竭评估评分升高或有同种异体造血干细胞移植或血液系统恶性肿瘤病史。伏立康唑治疗或播散性镰刀菌病均与治疗反应无明显相关性。侵袭性镰刀菌病可导致多器官衰竭,在 ICU 中与高死亡率相关。临床医生应密切监测有血液系统恶性肿瘤或干细胞移植病史的 ICU 患者,因为这些患者死亡风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/313a/10826781/c68469701c41/23-1221-F1.jpg

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