Emerging Invasive Fungal Infections: Clinical Features and Controversies in Diagnosis and Treatment Processes
Open Access
- 1 February 2020
- journal article
- research article
- Published by Taylor & Francis Ltd in Infection and Drug Resistance
- Vol. ume 13, 607-615
- https://doi.org/10.2147/idr.s237815
Abstract
Background: The diagnosis and treatment of invasive fungal infection (IFI) are still challenging due to its complexity and non-specificity. This study was aimed to investigate the clinical features, diagnosis process, and outcomes of patients with emerging IFIs. Methods: A retrospective review of emerging IFIs in adult patients at a university hospital in China was conducted; diagnoses were based on the criteria of EORTC/MSG 2008. Results: 145 IFI patients (pulmonary, intestinal and urinary) were enrolled in this study, including 80 proven (55.2%), 59 probable (40.7%), or 6 possible IFIs (4.1%). Among the 126 pulmonary IFIs, the positivity rate for sputum microscopy, sputum culture, and 1.3-ß-D-glucan (BG) test was 54.0%, 44.4%, and 37.3%, respectively. Among the 19 intestinal and urinary IFIs, routine examination of stool or urine and their culture were the main methods of detection. Positive results of 75 detected fungal strains from the samples showed that 30 cases were complicated with one or more bacterial infections. The average length of hospital stay of IFI patients was 14.0 (10.0, 20.0) days. The time from admission to antifungal therapy initiation (P< 0.001), liver cirrhosis (P< 0.001), hematological tumor (P< 0.001), coinfection (P=0.019) and immune diseases (P=0.025) were independent predictors of prolonged hospitalization. Conclusion: Delayed time was the primary predictor of prolonged hospitalization. This prediction is suggested to improve IFI diagnostic and therapeutic process of IFI to promote prognosis.This publication has 33 references indexed in Scilit:
- Infection and Drug ResistanceInfection and Drug Resistance, 2020
- Relationship between immune function recovery and infectious complications in patients following living donor liver transplantationHepatology Research, 2016
- Applicability of the EORTC/MSG criteria for IFD in clinical practiceAnnals of Hematology, 2014
- Population-Based Analysis of Invasive Fungal Infections, France, 2001–2010Emerging Infectious Diseases, 2014
- Six-Year Trend Analysis of Nosocomial Candidemia and Risk factors in Two Intensive Care Hospitals in Mato Grosso, Midwest Region of BrazilMycopathologia, 2013
- Emerging fungal threats to animal, plant and ecosystem healthNature, 2012
- The Diagnostic Value of Halo and Reversed Halo Signs for Invasive Mold Infections in Compromised HostsClinical Infectious Diseases, 2011
- Radiological findings of early invasive pulmonary aspergillosis in immune-compromised patientsHematological Oncology, 2009
- Revised Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus GroupClinical Infectious Diseases, 2008
- Long-Term CT Follow-Up in 40 Non-HIV Immunocompromised Patients with Invasive Pulmonary Aspergillosis: Kinetics of CT Morphology and Correlation with Clinical Findings and OutcomeAmerican Journal of Roentgenology, 2006