title: SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients.
abstract: OBJECTIVE
  We compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs).
  
  
  METHODS
  Prospective surveillance (2009-2011) of proven and probable FFIs was implemented in 23 Italian hospitals.
  
  
  RESULTS
  Out of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1 % for HAEs, 56.3 % for non-HAEs), and the localization was principally pulmonary (83.2 % for HAEs, 74.8 % for non-HAEs). Neutropenia was a risk factor for 89.4 % HAEs; the main underlying condition was corticosteroid treatment (52.9 %) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1 %). The overall mortality rate was 44.2 % among the HAEs and 35.3 % among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1 % for HAEs, 77.8 % for non-HAEs).
  
  
  CONCLUSIONS
  The epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients' setting.
authors.affiliation: Hygiene Section, Department of Biomedical Science and Human Oncology, University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy, mariateresa.montagna@uniba.it.
authors.forename: M T
authors.initials: MT
authors.lastname: Montagna
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authors.lastname: Puntillo
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authors.lastname: Venditti
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authors.lastname: Sambri
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authors.lastname: Di Bernardo
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authors.lastname: Barbui
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authors.lastname: Lo Cascio
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authors.lastname: Candoni
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authors.lastname: Sanguinetti
authors.forename: R
authors.initials: R
authors.lastname: Masciari
authors.forename: T
authors.initials: T
authors.lastname: Santantonio
authors.forename: S
authors.initials: S
authors.lastname: Andreoni
authors.forename: F
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authors.lastname: Barchiesi
authors.forename: P
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authors.lastname: Pecile
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authors.lastname: Farina
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authors.lastname: Viale
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authors.lastname: Specchia
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authors.initials: G
authors.lastname: Caggiano
authors.forename: L
authors.initials: L
authors.lastname: Pagano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003955:Diagnostic Tests, Routine; D005260:Female; D005658:Fungi / Q000145:classification* / Q000302:isolation & purification*; D019337:Hematologic Neoplasms / Q000150:complications; D006761:Hospitals; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008828:Microbiological Techniques / Q000379:methods; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D011446:Prospective Studies; D012042:Registries; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult