复康岛大学医院血液系统恶性肿瘤患者的侵袭性真菌感染（2018-2022）：一项观察性研究

Invasive fungal infections in patients with haematological malignancies at the University Hospital of Reunion Island (2018-2022): An observational study

MEDICAL MYCOLOGY

影响因子:2.3

分区:医学3区 / 兽医学2区传染病学3区真菌学3区

发表日期:2024 Oct 04

作者: Camille Estagnasié, Catherine Mohr, Laure Kamus, Patricia Zunic, Emmanuel Chirpaz, Marie-Pierre Moiton, Marie Lagrange-Xelot

DOI: 10.1093/mmy/myae102

摘要

侵袭性真菌感染是血液科患者的重要并发症，但在复康岛尚无相关研究。本研究旨在估算复康岛大学医院血液系统恶性肿瘤患者中侵袭性真菌感染的发病率。我们进行了一项描述性及双向回顾性研究，纳入2018年1月至2022年12月期间，符合欧洲肿瘤研究与抗真菌菌群（EORTC/MSG）2019标准，具有疑似、可能、概率或确诊侵袭性真菌感染的血液恶性肿瘤患者。数据来源于病历记录、ICD-10编码及实验室检测。共诊断出89例侵袭性真菌感染，涉及76名患者。五年发病率为每100人年1.7例（95%置信区间（CI）: 1.3-2）。最常见感染为侵袭性曲霉病（35/89，39%），其次为侵袭性念珠菌病（33/89，37%）、隐球菌病（7/89，8%）和肺孢子菌病（7/89，8%）。大多数感染发生在急性髓系白血病（32/89，36%）和淋巴瘤患者（26/89，29%）。六个月死亡率中，隐球菌病最高（71%），曲霉病（34%）和念珠菌病（33%）次之。血液系统患者中真菌感染的发病率和分布与欧洲队列类似，但隐球菌病较多，肺孢子菌感染较少，念珠菌血症中卡氏假丝酵母菌（Candida parapsilosis）的比例较高。

Abstract

Invasive fungal infections are a serious complication for haematology patients. However, there is no study on this subject in Reunion Island. The aim of this study was to estimate the incidence of invasive fungal infections in patients with haematological malignancies at the University Hospital of Reunion Island. We conducted a descriptive and ambispective study. We included any patient with haematological malignancy presenting with a putative, possible, probable, or proven invasive fungal infection, defined as per the criteria of the European Organisation for Research and Treatment of Cancer/Mycoses Study Group 2019, from January 2018 to December 2022. Data were collected from medical records and identified by ICD-10 coding and laboratory data. Eighty-nine invasive fungal infections were diagnosed in 76 patients. The 5-year incidence rate of invasive fungal infections was 1.7 per 100 person-years (95% Confidence Interval (CI) 1.3-2). Invasive aspergillosis was the most common infection (35/89, 39%), followed by invasive candidiasis (33/89, 37%), mucormycosis (7/89, 8%), and pneumocystosis (7/89, 8%). Most infections occurred in patients with acute myeloid leukaemia (32/89, 36%) and lymphoma (26/89, 29%). Six-month mortality was higher for mucormycosis (71%) than for aspergillosis (34%) and invasive candidiasis (33%). The incidence and distribution of fungal infections in haematology patients were similar to European cohorts, albeit with more mucormycosis, less pneumocystis, and a high proportion of Candida parapsilosis in candidemia.