Invasive fungal infections in patients with hematologic malignancies (aurora project): lights and shadows during 18-months surveillance.
The aim of this multicenter prospective study was to evaluate the incidence of invasive fungal infections (IFIs) in adult and pediatric patients with hematologic malignancies, involving nine nosocomial facilities in Southern Italy over a period of 18 months. Furthermore, results of an environmental microbial surveillance routinely carried out in some of the enrolled hospitals are reported. A total of 589 onco-hematological patients were enrolled and 27 IFIs were documented. The main infections were caused by yeasts, more than filamentous fungi (overall incidence of 2.7% and 1.9%, respectively). The yeasts were mainly represented by Candida spp. (87.5%), all isolated by blood cultures; C. parapsilosis was the most common species. Among mould infections, the most frequent site was the lung, with regard to aspergillosis (81.8%). In six of the 10 patients with suspected aspergillosis, the diagnosis was made by the detection of galactomannan and (1,3)-β-d-glucan antigens. The microbiological surveillance carried out on 156 air, 312 water and 312 surface samples revealed low environmental contamination: Alternaria alternata was the only fungus isolated from two surface samples. Our data, especially the low occurrence of filamentous fungi, suggest a particular local epidemiology. Further studies are needed to confirm this microbiological trend in onco-hematological patients in Southern Italy, the results of which might be helpful to improve the management of these patients.
Hygiene Section, Department of Biomedical Science and Human Oncology, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Maria Teresa
MT
Montagna
Hygiene Section, Department of Biomedical Science and Human Oncology, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Osvalda De
O
Giglio
Hygiene Section, Department of Biomedical Science and Human Oncology, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Christian
C
Napoli
Hygiene Section, Department of Biomedical Science and Human Oncology, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Grazia
G
Lovero
Hygiene Section, Department of Biomedical Science and Human Oncology, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Giuseppina
G
Caggiano
Hematology Section, Department of Pathological Anatomy, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Mario
M
Delia
Hematology Section, Department of Pathological Anatomy, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Domenico
D
Pastore
U.O. Pediatrics "F.Vecchio", A.O.U. Policlinico Consorziale, Piazza G. Cesare 11, 70124 Bari, Italy.
Nicola
N
Santoro
Hematology Section, Department of Pathological Anatomy, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Giorgina
G
Specchia
D000293:Adolescent; D000328:Adult; D000368:Aged; D000528:Alternaria / Q000302:isolation & purification; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002175:Candida / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D019337:Hematologic Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008351:Mannans / Q000032:analysis; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D011509:Proteoglycans; D055815:Young Adult; D047071:beta-Glucans / Q000032:analysis
D000970:Antineoplastic Agents; D008351:Mannans; D011509:Proteoglycans; D047071:beta-Glucans; C012990:galactomannan; C010770:polysaccharide-K; D005690:Galactose