Results of treatment for candidemia in patients with blood system tumors
AIM: To study the etiology, clinical manifestations, risk factors, and results of treatment for candidemia (CE) in patients with blood system tumors/MATERIAL AND METHODS: The investigation included the patients with CE and hemoblastoses treated at the Hematology Research Center, Ministry of Health o...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Russian |
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"Consilium Medicum" Publishing house
2013-11-01
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| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/view/31374 |
| _version_ | 1818524391800045568 |
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| author | G A Kliasova E V Blokhina A N Gracheva S K Kravchenko E N Parovichnikova G M Galstian |
| author_facet | G A Kliasova E V Blokhina A N Gracheva S K Kravchenko E N Parovichnikova G M Galstian |
| author_sort | G A Kliasova |
| collection | DOAJ |
| description | AIM: To study the etiology, clinical manifestations, risk factors, and results of treatment for candidemia (CE) in patients with blood system tumors/MATERIAL AND METHODS: The investigation included the patients with CE and hemoblastoses treated at the Hematology Research Center, Ministry of Health of the Russian Federation, in 2006 to 2012. The diagnosis of CE was established according to the single isolation of Candida spp. from blood cultures and the presence of infection symptoms/RESULTS: Over 7 years, CE was diagnosed in 57 patients aged 17 to 77 years (median age 48 years). Among the patients with CE, there was a preponderance of those with lymphomas (54%) and acute leukemias (30%). The pathogens of CE were C. albicans (33%), C. guilliermondii (26%), С. parapsilosis (12%), С. krusei (8%), C. lusitaniae (5%), С. famata (4%), C. tropicalis (4%), С. glabrata (4%), and C. pelliculosa (4%). The major risk factors were polychemotherapy (85%), granulocytopenia (63%), mucosal Candida spp. colonization (82%), the presence of central venous catheter (CVC) (97%), antibiotics (100%), and glucocorticosteroids (70%). The infection occurred with the intake of an antifungal agent in 33% of the patients; 60% had concomitant infections of other etiology. Antifungal agents were given to 52 (91%) patients. Within 30 days after CE diagnosis, 20 (35%) patients died; of them 12 (60%) patients showed tumor progression concurrent with the infection. The cure rate for CE was significantly higher in the use of echinocandin as a first-line drug (92%), in complete or partial remission in hemoblastosis (90%), CVC removal (76%) and in the administration of an antifungal drug on day 1 of detection of positive blood cultures (75%). The cure rate was significantly lower when septic shock developed and a patient was transferred to an intensive care unit (15%), when amphotericin B was used as a first-line drug (45%), when granulocytopenia occurred (53%), or glucocorticoids were given (55%)/CONCLUSION: Candida non-albicans constitute a high proportion among the pathogens of CE. A number of risk factors influencing survival rates in CE have been identified. It is crucial to use echinocandin as a first-line agent as soon as possible after isolation of Candida spp. from blood cultures. |
| first_indexed | 2024-12-11T05:56:31Z |
| format | Article |
| id | doaj.art-9067d2d176744148ad5768b20d868490 |
| institution | Directory Open Access Journal |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| last_indexed | 2024-12-11T05:56:31Z |
| publishDate | 2013-11-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj.art-9067d2d176744148ad5768b20d8684902022-12-22T01:18:40Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422013-11-018511475328390Results of treatment for candidemia in patients with blood system tumorsG A KliasovaE V BlokhinaA N GrachevaS K KravchenkoE N ParovichnikovaG M GalstianAIM: To study the etiology, clinical manifestations, risk factors, and results of treatment for candidemia (CE) in patients with blood system tumors/MATERIAL AND METHODS: The investigation included the patients with CE and hemoblastoses treated at the Hematology Research Center, Ministry of Health of the Russian Federation, in 2006 to 2012. The diagnosis of CE was established according to the single isolation of Candida spp. from blood cultures and the presence of infection symptoms/RESULTS: Over 7 years, CE was diagnosed in 57 patients aged 17 to 77 years (median age 48 years). Among the patients with CE, there was a preponderance of those with lymphomas (54%) and acute leukemias (30%). The pathogens of CE were C. albicans (33%), C. guilliermondii (26%), С. parapsilosis (12%), С. krusei (8%), C. lusitaniae (5%), С. famata (4%), C. tropicalis (4%), С. glabrata (4%), and C. pelliculosa (4%). The major risk factors were polychemotherapy (85%), granulocytopenia (63%), mucosal Candida spp. colonization (82%), the presence of central venous catheter (CVC) (97%), antibiotics (100%), and glucocorticosteroids (70%). The infection occurred with the intake of an antifungal agent in 33% of the patients; 60% had concomitant infections of other etiology. Antifungal agents were given to 52 (91%) patients. Within 30 days after CE diagnosis, 20 (35%) patients died; of them 12 (60%) patients showed tumor progression concurrent with the infection. The cure rate for CE was significantly higher in the use of echinocandin as a first-line drug (92%), in complete or partial remission in hemoblastosis (90%), CVC removal (76%) and in the administration of an antifungal drug on day 1 of detection of positive blood cultures (75%). The cure rate was significantly lower when septic shock developed and a patient was transferred to an intensive care unit (15%), when amphotericin B was used as a first-line drug (45%), when granulocytopenia occurred (53%), or glucocorticoids were given (55%)/CONCLUSION: Candida non-albicans constitute a high proportion among the pathogens of CE. A number of risk factors influencing survival rates in CE have been identified. It is crucial to use echinocandin as a first-line agent as soon as possible after isolation of Candida spp. from blood cultures.https://ter-arkhiv.ru/0040-3660/article/view/31374candidemiainvasive candidiasishemoblastosesechinocandin |
| spellingShingle | G A Kliasova E V Blokhina A N Gracheva S K Kravchenko E N Parovichnikova G M Galstian Results of treatment for candidemia in patients with blood system tumors Терапевтический архив candidemia invasive candidiasis hemoblastoses echinocandin |
| title | Results of treatment for candidemia in patients with blood system tumors |
| title_full | Results of treatment for candidemia in patients with blood system tumors |
| title_fullStr | Results of treatment for candidemia in patients with blood system tumors |
| title_full_unstemmed | Results of treatment for candidemia in patients with blood system tumors |
| title_short | Results of treatment for candidemia in patients with blood system tumors |
| title_sort | results of treatment for candidemia in patients with blood system tumors |
| topic | candidemia invasive candidiasis hemoblastoses echinocandin |
| url | https://ter-arkhiv.ru/0040-3660/article/view/31374 |
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