title: Fungal colonization of the respiratory tract in allogeneic and autologous hematopoietic stem cell transplant recipients: a study of 573 transplanted patients.
abstract: BACKGROUND
  Fungal colonization and infections remain a major cause of infection morbidity and mortality following hematopoietic stem cell transplantation (HSCT) in patients with hematological malignancies. The aim of this study was to analyze the spectrum of fungal microflora of the respiratory tract (oral cavity, pharynx, epiglottis, and sputum) in patients undergoing HSCT and to evaluate the relationship between HSCT type and incidence of mycotic colonization and infections.
  
  
  METHODS
  Retrospective analysis of fungal isolates collected from the respiratory tract (oral cavity, pharynx, epiglottis, and sputum) of 573 patients undergoing HSCT was performed.
  
  
  RESULTS
  The overall rate of fungal colonization in patients undergoing HSCT was 8.7%. Patients undergoing allogeneic HSCT were statistically significantly more often colonized (12.95%) compared to autologous HSCT recipients (4.7%). Colonizing cultures were mainly C. albicans and C. krusei, and sporadically C. glabrata, C. famata, Aspergillus spp. and Saccharomyces cerevisiae. C. albicans was the most frequent species found in isolates from the pharynx, sputum, and oral cavity collected from patients undergoing HSCT. Aspergillosis was more common after allogeneic than after autologous HSCT. The pharynx was the most frequently colonized site.
  
  
  CONCLUSIONS
  Allogeneic HSCT recipients are more susceptible to fungal infections compared to the autologous group. Selection of species during prophylaxis and antifungal therapy requires developing more effective prevention and treatment strategies based on new antifungal drugs and microbe-specific diagnoses.
authors.affiliation: ENT Department, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Markowski
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Helbig
authors.affiliation: ENT Department, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Widziszowska
authors.affiliation: Department of Human Anatomy, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Wirginia
authors.initials: W
authors.lastname: Likus
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Sławomira
authors.initials: S
authors.lastname: Kyrcz-Krzemień
authors.affiliation: Department of Microbilology, Mielęcki Memorial Hospital, Katowice, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Jarosz
authors.affiliation: Outpatient Clinic for Treatment of Chronic Pain, Sosnowiec, Poland.
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Dziubdziela
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Mirosław
authors.initials: M
authors.lastname: Markiewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D064592:Autografts; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D012441:Saccharomyces cerevisiae / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000935:Antifungal Agents