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antifungal hematology

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https://www.readbyqxmd.com/read/28138379/non-invasive-methods-to-diagnose-fungal-infections-in-pediatric-patients-with-hematologic-disorders
#1
Parisa Badiee, Zahra Hashemizadeh, Mani Ramzi, Mohammad Karimi, Rasoul Mohammadi
BACKGROUND: Invasive fungal infection (IFIs) is a major infectious complication in immunocompromised patients. Early diagnosis and initiation of antifungal therapy is important to achieve the best outcome. OBJECTIVES: The current study aimed to investigate the incidence of IFIs and evaluate the diagnostic performance of non-invasive laboratory tests: serologic (β-D-glucan, galactomannan) and molecular (nested polymerase chain reaction) tests to diagnose fungal infections in hematologic pediatric patients...
November 2016: Jundishapur Journal of Microbiology
https://www.readbyqxmd.com/read/28138378/the-frequency-antifungal-susceptibility-and-enzymatic-profiles-of-candida-species-isolated-from-neutropenic-patients
#2
Maral Gharaghani, Ali Rezaei-Matehkolaei, Ali Zarei Mahmoudabadi, Bijan Keikhaei
BACKGROUND: Neutropenia, as a predisposing factor for invasive candidiasis, is defined as a reduction in neutrophil count to less than 1500/mm(3). It is a common condition in patients with hematological malignancy and cytostatic chemotherapy. Extensive chemotherapy and prophylaxis with antifungals have increased the resistance of Candida isolates to antifungal drugs. Although, Candida albicans is the most common causative agent among neutropenic patients, there is an increasing rate of non-albicans species...
November 2016: Jundishapur Journal of Microbiology
https://www.readbyqxmd.com/read/28131991/is-a-biomarker-based-diagnostic-strategy-for-invasive-aspergillosis-cost-effective-in-high-risk-haematology-patients
#3
N Macesic, C O Morrissey, D Liew, M A Bohensky, S C-A Chen, N M Gilroy, S T Milliken, J Szer, M A Slavin
Empirical antifungal therapy is frequently used in hematology patients at high risk of invasive aspergillosis (IA), with substantial cost and toxicity. Biomarkers for IA aim for earlier and more accurate diagnosis and targeted treatment. However, data on the cost-effectiveness of a biomarker-based diagnostic strategy (BDS) are limited. We evaluated the cost effectiveness of BDS using results from a randomized controlled trial (RCT) and individual patient costing data. Data inputs derived from a published RCT were used to construct a decision-analytic model to compare BDS (Aspergillus galactomannan and PCR on blood) with standard diagnostic strategy (SDS) of culture and histology in terms of total costs, length of stay, IA incidence, mortality, and years of life saved...
January 27, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28115858/cost-effectiveness-analysis-of-combination-antifungal-therapy-with-voriconazole-and-anidulafungin-versus-voriconazole-monotherapy-for-primary-treatment-of-invasive-aspergillosis-in-spain
#4
Santiago Grau, Jose Ramon Azanza, Isabel Ruiz, Carlos Vallejo, Josep Mensa, Johan Maertens, Werner J Heinz, Jon Andoni Barrueta, Carmen Peral, Francisco Jesús Mesa, Miguel Barrado, Claudie Charbonneau, Darío Rubio-Rodríguez, Carlos Rubio-Terrés
OBJECTIVE: According to a recent randomized, double-blind clinical trial comparing the combination of voriconazole and anidulafungin (VOR+ANI) with VOR monotherapy for invasive aspergillosis (IA) in patients with hematologic disease or with hematopoietic stem cell transplant, mortality was lower after 6 weeks with VOR+ANI than with VOR monotherapy in a post hoc analysis of patients with galactomannan-based IA. The objective of this study was to compare the cost-effectiveness of VOR+ANI with VOR, from the perspective of hospitals in the Spanish National Health System...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28089099/clinical-characteristics-and-outcome-of-invasive-fungal-infections-in-pediatric-acute-myeloid-leukemia-patients-in-a-medical-center-in-taiwan
#5
Gu-Lung Lin, Hsiu-Hao Chang, Chun-Yi Lu, Chung-Ming Chen, Meng-Yao Lu, Ping-Ing Lee, Shiann-Tarng Jou, Yung-Li Yang, Li-Min Huang, Luan-Yin Chang
BACKGROUND: Invasive fungal infection (IFI) causes significant morbidity and mortality in patients with hematological malignancies, especially those with acute myeloid leukemia (AML), recurrent acute leukemia, high-risk acute lymphoblastic leukemia, and after allogeneic hematopoietic stem cell transplantation. The study aimed to investigate the clinical characteristics and outcome of IFIs in pediatric AML patients in a medical center in Taiwan. METHODS: We performed retrospective chart reviews...
December 19, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28011902/ecil-6-guidelines-for-the-treatment-of-invasive-candidiasis-aspergillosis-and-mucormycosis-in-leukemia-and-hematopoietic-stem-cell-transplant-patients
#6
Frederic Tissot, Samir Agrawal, Livio Pagano, Georgios Petrikkos, Andreas H Groll, Anna Skiada, Cornelia Lass-Flörl, Thierry Calandra, Claudio Viscoli, Raoul Herbrecht
The European Conference on Infections in Leukemia (ECIL) provides recommendations for diagnostic strategies and prophylactic, pre-emptive or targeted therapy strategies for various types of infection in patients with hematological malignancies or hematopoietic stem cell transplantation recipients. Meetings are held every two years since 2005 and evidence-based recommendations are elaborated after evaluation of the literature and discussion among specialists of nearly all European countries. In this manuscript, the ECIL group presents the 2015-update of the recommendations for the targeted treatment of invasive candidiasis, aspergillosis and mucormycosis...
December 23, 2016: Haematologica
https://www.readbyqxmd.com/read/27939578/disseminated-aspergillosis-in-an-immunocompetent-patient-with-detectable-bis-methylthio-gliotoxin-and-negative-galactomannan
#7
Matxalen Vidal-García, Pilar Sáncehez-Chueca, María Pilar Domingo, Carlos Ballester, Lourdes Roc, Isabel Ferrer, María José Revillo, Julián Pardo, Eva María Gálvez, Antonio Rezusta
BACKGROUND: Disseminated invasive aspergillosis is an exceptional finding in immunocompetent hosts. As in immunocompromised patients, it has high mortality rates. Early diagnostic methods are required in order to properly manage the patient. Bis(methylthio)gliotoxin (bmGT) is a novel biomarker, useful in onco-hematological patients. CASE REPORT: A 70-year-old male, with non-insulin dependent type II diabetes mellitus and a past surgery history of aortic valve replacement with coronary by-pass five years ago, was seen in the emergency department with blurred vision...
December 8, 2016: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/27927037/clinical-hepatotoxicity-associated-with-antifungal-agents
#8
Ioannis Kyriakidis, Athanasios Tragiannidis, Silke Munchen, Andreas H Groll
Invasive fungal diseases (IFDs) are a leading cause of morbidity and mortality among immunocompromised patients with bone marrow failure syndromes, hematological malignancies, hematopoietic stem cell transplantation (HSCT), those admitted in intensive care units (ICUs) and those with prolonged febrile neutropenia. IFDs occur in a setting of multiple morbidities and are associated with case fatality rates between 30 and 70%. Along with the development of classes and compounds, the last two decades have seen substantial improvements in the prevention and management of these infections and an overall increased use of antifungal agents...
December 16, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27918884/acute-invasive-fungal-rhinosinusitis-presentation-of-19-cases-review-of-the-literature-and-a-new-classification-system
#9
Onur Ergun, Emel Tahir, Oguz Kuscu, Burce Ozgen, Taner Yilmaz
PURPOSE: The aim of this study was to determine the correlation between acute invasive fungal rhinosinusitis (AIFRS) and underlying diseases, micro-organisms, presenting symptoms, extent of disease, radiologic findings, and outcomes and propose a new classification system. MATERIALS AND METHODS: The data of 19 AIFRS cases were analyzed retrospectively. Magnetic resonance imaging and computed tomography were performed in all patients preoperatively. All patients underwent at least 1 surgical debridement...
November 15, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27915306/a-consort-analysis-of-randomised-controlled-trials-for-the-treatment-of-invasive-aspergillosis
#10
Brian L Jones, Malcolm D Richardson, Patricia M Ingram, Samir G Agrawal
There is no assessment of the reporting quality of antifungal randomized, controlled trials (RCT), upon which guidelines for the treatment of invasive aspergillosis (IA) in patients with hematological malignancy are based. Trial reports were identified through Trip, Cochrane, Medline, and Embase database searches. Report quality was assessed using the 25-item CONSORT checklist and a rating scale of 1 (strongly disagree) to 4 (strongly agree). The primary endpoint was quality as assessed by mean group-scores among papers published at the time of the most recent IA treatment guidelines...
December 3, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27915303/candida-species-isolated-from-different-body-sites-and-their-antifungal-susceptibility-pattern-cross-analysis-of-candida-albicans-and-candida-glabrata-biofilms
#11
Valentina Cataldi, Emanuela Di Campli, Paolo Fazii, Tonino Traini, Luigina Cellini, Mara Di Giulio
Candida species are regular commensal in humans, but-especially in immunocompromised patients-they represent opportunistic pathogens giving rise to systemic infection. The aim of the present work was to isolate and characterize for their antifungal profile Candida species from different body sites and to analyze the biofilms produced by C. albicans and C. glabrata isolates. Eighty-one strains of Candida species from 77 patients were identified. Epidemiological study showed that the most isolated species were C...
December 2, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27904738/recent-developments-in-the-management-of-invasive-fungal-infections-in-patients-with-oncohematological-diseases
#12
REVIEW
Markus Ruhnke, Stefan Schwartz
Patients with hematological cancer have a high risk of invasive fungal diseases (IFDs). These infections are mostly life threatening and an early diagnosis and initiation of appropriate antifungal therapy are essential for the clinical outcome. Most commonly, Aspergillus and Candida species are involved. However, other non-Aspergillus molds are increasingly be identified in cases of documented IFDs. Important risk factors are long lasting granulocytopenia with neutrophil counts below 500/μl for more than 10 days or graft-versus-host disease resulting from allogeneic stem-cell transplantation...
December 2016: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/27904061/diagnosis-and-treatment-of-mucormycosis-in-patients-with-hematological-malignancies
#13
Yuki Asano-Mori
The risk of invasive fungal infections (IFIs) is extremely high in patients with hematological malignancies due to the prolonged and profound neutropenia and immunosuppression after chemotherapy and hematopoietic stem cell transplantation. There has been increasing interest in mucormycosis despite its relatively uncommon occurrence, because occasional breakthrough infections have been observed under anti-aspergillus prophylaxis. The aggressive nature of mucormycosis easily leads to high mortality because of delays in diagnosis and incorrect treatment decisions, which are due in part to lack of adjunctive diagnostic tools and having similar clinical and radiological features with aspergillosis...
2016: Medical Mycology Journal
https://www.readbyqxmd.com/read/27903025/-antifungal-medication-new-substances-new-experiences
#14
Dieter Buchheidt, Wolf-Karsten Hofmann
The incidence of life threatening invasive fungal infections in patients with hematological malignancies during intensive chemotherapy or after hematopoetic stem cell transplantation, patients after solid organ transplantation, ICU patients and premature infants is rising. Mortality rates of invasive fungal infections, caused by Aspergillus species or mucormycetes, may reach 100%, in spite of considerable progress in diagnosis, antifungal prophylaxis and therapy. Comprehensive, profound knowledge of specific diagnostic and current treatment algorithms is essential to improve the prognosis of patients suffering from systemic fungal infections; this article encompasses recent developments in the field of antifungal treatment...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27837506/serological-approaches
#15
Barbora Weinbergerova, Iva Kocmanova, Zdenek Racil, Jiri Mayer
The diagnosis of invasive fungal diseases (IFD) based on clinical, radiological, and conventional microbiological findings is not reliable and is often delayed. Non-culture-based methods with higher sensitivity and specificity may reduce diagnostic time and result in decreased IFD morbidity and mortality. These methods are now increasingly used to manage patients at risk of IFD. Among available biomarkers, fungal antigens have been investigated as an aid to early diagnosis and are predominantly used as screening tests to prompt antifungal treatment mainly in patients with hematological malignancies...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27837502/host-derived-biomarkers-for-risk-assessment-of-invasive-fungal-diseases
#16
Cristina Cunha, Samuel M Gonçalves, Agostinho Carvalho
Invasive fungal diseases are major complications associated with the treatment of hematologic malignancies. The integration of host-derived biomarkers into clinical processes to predict the risk and progression of fungal disease is a promising approach in immunocompromised patients. Recent insights into human antifungal immunity have highlighted the remarkable influence of host genetics in modulating susceptibility to infection. In this chapter, we describe protocols to examine human genetic variation and to assess its functional consequences using the pattern recognition receptor PTX3 as an example...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27837498/current-algorithms-in-fungal-diagnosis-in-the-immunocompromised-host
#17
Thomas Lehrnbecher, Karsten Becker, Andreas H Groll
Invasive fungal diseases (IFDs) are a major cause of morbidity and mortality in immunocompromised patients such as patients with hematological malignancies or allogeneic hematopoietic stem cell transplant recipients. Whereas the definite diagnosis of IFD requires invasive diagnostic procedures, imaging and noninvasive diagnostic assays may help in decision making with regard to the institution and the choice of antifungal agents, the duration of therapy, surgical intervention, and monitoring of fungal manifestations...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27819257/preemptive-antifungal-therapy-for-febrile-neutropenic-hematological-malignancy-patients-in-china
#18
Wei Yuan, Jinhai Ren, Xiaonan Guo, Xiaoling Guo, Shengxin Cai
BACKGROUND The aim of this study was to evaluate the efficiency, adverse effects, and pharmacoeconomic impact of empirical and preemptive antifungal therapy for febrile neutropenic hematological malignancy patients in China. MATERIAL AND METHODS Patients with febrile neutropenia during hematological malignancy were randomly divided into an empirical group and a preemptive group. The preemptive antifungal treatment was initiated if patient status was confirmed by clinical manifestation, imaging diagnosis, 1-3-β-D glucan(G) testing, and galactomannan (GM) test...
November 7, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27815226/utility-of-the-serum-galactomannan-assay-for-the-diagnosis-of-invasive-aspergillosis-in-children-with-acute-lymphoblastic-leukemia
#19
Gulhadiye Avcu, Deniz Yilmaz Karapinar, Ayse Burcu Akinci, Zuhal Onder Sivis, Akkiz Sahin, Zumrut Sahbudak Bal, Suleyha Hilmioglu Polat, Dilek Yesim Metin, Fadil Vardar, Yesim Aydinok
OBJECTIVES: Invasive aspergillosis (IA) is an important cause of mortality and morbidity in children with hematological malignancies. The monitoring of serum galactomannan (GM) antigen is considered useful in the diagnosis of IA . The aim of this study was to determine the utility of serum GM monitoring in the early diagnosis of IA and the role of positive antigenemia in the management of children with acute lymphoblastic leukemia (ALL). METHODS: The cases of 141 children who were being treated for ALL in the Division of Pediatric Hematology of the Medical School of Ege University between January 2006 and February 2015 were reviewed retrospectively...
January 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27800196/chronic-disseminated-candidiasis-complicated-by-immune-reconstitution-inflammatory-syndrome-in-child-with-acute-lymphoblastic-leukemia
#20
Olga Zając-Spychała, Bogna Ukielska, Katarzyna Jończyk-Potoczna, Benigna Konatkowska, Jacek Wachowiak
Hepatosplenic candidiasis also known as chronic disseminated candidiasis is a rare manifestation of invasive fungal infection typically observed in patients with acute leukemia in prolonged, deep neutropenia. Immune reconstitution inflammatory syndrome (IRIS) is an inflammatory disorder triggered by rapid resolution of neutropenia. Diagnosis and treatment of IRIS are still challenging due to a variety of clinical symptoms, lack of certain diagnostic criteria, and no standards of treatment. The diagnosis of IRIS is even more difficult in patients with hematological malignancies complicated by "probable" invasive fungal infection, when fungal pathogen is still uncertain...
2016: Case Reports in Hematology
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