Details

Autor(en) / Beteiligte

• Cag, Yasemin
• Erdem, Hakan
• Gunduz, Mehmet
• Komur, Suheyla
• Ankarali, Handan
• Ural, Serap
• Tasbakan, Meltem
• Tattevin, Pierre
• Tombak, Anil
• Ozturk-Engin, Derya
• Tartar, Ayse Sagmak
• Batirel, Ayse
• Tekin, Recep
• Duygu, Fazilet
• Caskurlu, Hulya
• Kurtaran, Behice
• Durdu, Bulent
• Haciseyitoglu, Demet
• Rello, Jordi
• Sirmatel, Fatma
• Cascio, Antonio
• Lakatos, Botond
• Oncu, Serkan
• Willke, Ayse
• Puca, Edmond
• Koc, Meliha Meric
• Korkmaz, Pinar
• Karabay, Oguz
• Guner, Rahmet
• Caylak, Selmin Dirgen
• Keceli, Sema
• Cesur, Salih
• Menekse, Sirin
• Ergen, Pinar
• Tasbakan, Mehmet Sezai
• Erdem, Ayşegül
• Cag, Yakup
• Akcay, Emine
• Fasciana, Teresa
• Giammanco, Anna
• Girgin, Rabia Burçin
• Agalar, Canan
• Vahaboglu, Haluk

Titel

Survival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI study

Ist Teil von

• European journal of internal medicine, 2022-06, Vol.100, p.56-61

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2022

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• •Our study is a multicenter, international study investigating prognostic factors of ROCM.•Diabetes represented 56.8% of the underlying diseases, followed by hematological malignancies occurring in one-third of patients.•Confusion at admission, nosocomial infections, and prior antifungal exposure were independent factors associated with mortality.•Extensive surgical debridement and prior sinusitis history were independent factors associated with survival.•Improving source control and preventing nosocomial infections will improve survival. Mucormycosis is an emerging aggressive mold infection. This study aimed to assess the outcome of hospitalized adults with rhino-orbito-cerebral mucormycosis (ROCM). The secondary objective was to identify prognostic factors in this setting. This study was an international, retrospective, multicenter study. Patients’ data were collected from 29 referral centers in 6 countries. All qualified as “proven cases” according to the EORTC/MSGERC criteria. We included 74 consecutive adult patients hospitalized with ROCM. Rhino-orbito-cerebral type infection was the most common presentation (n = 43; 58.1%) followed by rhino-orbital type (n = 31; 41.9%). Twenty (27%) had acquired nosocomial bacterial infections. A total of 59 (79.7%) patients (16 in combination) received appropriate antifungal treatment with high-doses of liposomal amphotericin B. Fifty-six patients (75.7%) underwent curative surgery. Thirty-five (47.3%) required intensive care unit admission (27; 36.5% under mechanical ventilation). Hospital survival was 56.8%, being reduced to 7.4% in patients with invasive mechanical ventilation. A multivariate binary backward logistic regression model identified confusion at admission (OR 11.48), overlapping hospital-acquired infection (OR 10.27), use of antifungal treatment before diagnosis (OR 10.20), no surgical debridement (OR 5.92), and the absence of prior sinusitis (OR 6.32) were independently associated with increased risk for death. Today, ROCM still has high mortality rate. Improving source control, rational therpy, and preventing nosocomial infections may improve survival in this severe infection.