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Clin Infect Dis. 2015 Aug 1;61(3):324-31. doi: 10.1093/cid/civ293. Epub 2015 Apr 13.

Epidemiology and outcome of fungemia in a cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031).

Author information

1
Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne Department I of Internal Medicine, University Hospital Cologne Clinical Trials Centre Cologne, ZKS Köln, BMBF 01KN1106, and German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany.
2
Institut Gustave Roussy Département de Soins Aigus, Institut Gustave-Roussy, Villejuif, France.
3
Ankara University School of Medicine, Turkey.
4
Santa Maria Misericordia Hospital, Udine, Italy.
5
Department of Medicine, Section of Infectious Diseases, Hacettepe University Medical School, Ankara, Turkey.
6
University College London, United Kingdom.
7
Infectious Diseases Service, Department of Medicine, Lausanne University Hospital, Switzerland.
8
European Organisation for Research and Treatment of Cancer (EORTC).
9
Institut Jules Bordet, Université Libre de Bruxelles, Belgium.
10
University Medical Centre St Radboud, Nijmegen, The Netherlands.

Erratum in

Abstract

BACKGROUND:

Anti-cancer treatment and the cancer population have evolved since the last European Organisation for Research and Treatment of Cancer (EORTC) fungemia survey, and there are few recent large epidemiological studies.

METHODS:

This was a prospective cohort study including 145 030 admissions of patients with cancer from 13 EORTC centers. Incidence, clinical characteristics, and outcome of fungemia were analyzed.

RESULTS:

Fungemia occurred in 333 (0.23%; 95% confidence interval [CI], .21-.26) patients, ranging from 0.15% in patients with solid tumors to 1.55% in hematopoietic stem cell transplantation recipients. In 297 evaluable patients age ranged from 17 to 88 years (median 56 years), 144 (48%) patients were female, 165 (56%) had solid tumors, and 140 (47%) had hematological malignancies. Fungemia including polymicrobial infection was due to: Candida spp. in 267 (90%), C. albicans in 128 (48%), and other Candida spp. in 145 (54%) patients. Favorable overall response was achieved in 113 (46.5%) patients by week 2. After 4 weeks, the survival rate was 64% (95% CI, 59%-70%) and was not significantly different between Candida spp. Multivariable logistic regression identified baseline septic shock (odds ratio [OR] 3.04, 95% CI, 1.22-7.58) and tachypnoea as poor prognostic factors (OR 2.95, 95% CI, 1.66-5.24), while antifungal prophylaxis prior to fungemia (OR 0.20, 95% CI, .06-.62) and remission of underlying cancer (OR, 0.18; 95% CI, .06-.50) were protective.

CONCLUSIONS:

Fungemia, mostly due to Candida spp., was rare in cancer patients from EORTC centers but was associated with substantial mortality. Antifungal prophylaxis and remission of cancer predicted better survival.

KEYWORDS:

cancer; candida; candidemia; leukemia

PMID:
25870323
DOI:
10.1093/cid/civ293
[Indexed for MEDLINE]

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