Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control Study
Comprehensive data on emerging invasive fungal infections (EIFIs) in the critically ill are scarce. We conducted a case-control study to characterize EIFIs in patients admitted to a French medical ICU teaching hospital from 2006 to 2019. Among 6900 patients, 26 (4 per 1000) had an EIFI: <i>Muc...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/7/5/330 |
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| author | Romaric Larcher Laura Platon Matthieu Amalric Vincent Brunot Noemie Besnard Racim Benomar Delphine Daubin Patrice Ceballos Philippe Rispail Laurence Lachaud Nathalie Bourgeois Kada Klouche |
| author_facet | Romaric Larcher Laura Platon Matthieu Amalric Vincent Brunot Noemie Besnard Racim Benomar Delphine Daubin Patrice Ceballos Philippe Rispail Laurence Lachaud Nathalie Bourgeois Kada Klouche |
| author_sort | Romaric Larcher |
| collection | DOAJ |
| description | Comprehensive data on emerging invasive fungal infections (EIFIs) in the critically ill are scarce. We conducted a case-control study to characterize EIFIs in patients admitted to a French medical ICU teaching hospital from 2006 to 2019. Among 6900 patients, 26 (4 per 1000) had an EIFI: <i>Mucorales</i> accounted for half, and other isolates were mainly <i>Saprochaete</i>, <i>Fusarium</i> and <i>Scedosporium</i>. EIFIs occurred mostly in patients with immunosuppression and severe critical illness. Antifungal treatments (mainly amphotericin B) were administered to almost all patients, whereas only 19% had surgery. In-ICU, mortality was high (77%) and associated with previous conditions such as hematological malignancy or cancer, malnutrition, chronic kidney disease and occurrence of acute respiratory distress syndrome and/or hepatic dysfunction. Day-90 survival rates, calculated by the Kaplan–Meier method, were similar between patients with EIFIs and a control group of patients with aspergillosis: 20%, 95% CI (9- 45) versus 18%, 95% CI (8- 45) (log-rank: <i>p</i> > 0.99). ICU management of such patients should be assessed on the basis of underlying conditions, reversibility and acute event severity rather than the mold species. |
| first_indexed | 2024-03-10T12:00:18Z |
| format | Article |
| id | doaj.art-d54428c8e64847ad87c5224c2a323d64 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T12:00:18Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-d54428c8e64847ad87c5224c2a323d642023-11-21T17:01:12ZengMDPI AGJournal of Fungi2309-608X2021-04-017533010.3390/jof7050330Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control StudyRomaric Larcher0Laura Platon1Matthieu Amalric2Vincent Brunot3Noemie Besnard4Racim Benomar5Delphine Daubin6Patrice Ceballos7Philippe Rispail8Laurence Lachaud9Nathalie Bourgeois10Kada Klouche11Intensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090 Montpellier, FranceIntensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090 Montpellier, FranceIntensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090 Montpellier, FranceIntensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090 Montpellier, FranceIntensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090 Montpellier, FranceIntensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090 Montpellier, FranceIntensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090 Montpellier, FranceHematology Department, Saint Eloi Hospital, Montpellier University Hospital, 34090 Montpellier, FranceMycology and Parasitology Laboratory, Lapeyronie Hospital, Montpellier University Hospital, 34090 Montpellier, FranceMycology and Parasitology Laboratory, Lapeyronie Hospital, Montpellier University Hospital, 34090 Montpellier, FranceMycology and Parasitology Laboratory, Lapeyronie Hospital, Montpellier University Hospital, 34090 Montpellier, FranceIntensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090 Montpellier, FranceComprehensive data on emerging invasive fungal infections (EIFIs) in the critically ill are scarce. We conducted a case-control study to characterize EIFIs in patients admitted to a French medical ICU teaching hospital from 2006 to 2019. Among 6900 patients, 26 (4 per 1000) had an EIFI: <i>Mucorales</i> accounted for half, and other isolates were mainly <i>Saprochaete</i>, <i>Fusarium</i> and <i>Scedosporium</i>. EIFIs occurred mostly in patients with immunosuppression and severe critical illness. Antifungal treatments (mainly amphotericin B) were administered to almost all patients, whereas only 19% had surgery. In-ICU, mortality was high (77%) and associated with previous conditions such as hematological malignancy or cancer, malnutrition, chronic kidney disease and occurrence of acute respiratory distress syndrome and/or hepatic dysfunction. Day-90 survival rates, calculated by the Kaplan–Meier method, were similar between patients with EIFIs and a control group of patients with aspergillosis: 20%, 95% CI (9- 45) versus 18%, 95% CI (8- 45) (log-rank: <i>p</i> > 0.99). ICU management of such patients should be assessed on the basis of underlying conditions, reversibility and acute event severity rather than the mold species.https://www.mdpi.com/2309-608X/7/5/330intensive care unitoutcomeinvasive fungal infectionsmucormycosis<i>Fusarium</i><i>Scedosporium</i> |
| spellingShingle | Romaric Larcher Laura Platon Matthieu Amalric Vincent Brunot Noemie Besnard Racim Benomar Delphine Daubin Patrice Ceballos Philippe Rispail Laurence Lachaud Nathalie Bourgeois Kada Klouche Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control Study Journal of Fungi intensive care unit outcome invasive fungal infections mucormycosis <i>Fusarium</i> <i>Scedosporium</i> |
| title | Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control Study |
| title_full | Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control Study |
| title_fullStr | Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control Study |
| title_full_unstemmed | Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control Study |
| title_short | Emerging Invasive Fungal Infections in Critically Ill Patients: Incidence, Outcomes and Prognosis Factors, a Case-Control Study |
| title_sort | emerging invasive fungal infections in critically ill patients incidence outcomes and prognosis factors a case control study |
| topic | intensive care unit outcome invasive fungal infections mucormycosis <i>Fusarium</i> <i>Scedosporium</i> |
| url | https://www.mdpi.com/2309-608X/7/5/330 |
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