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Monzó-Gallo P, Lopera C, Badía-Tejero AM, Machado M, García-Rodríguez J, Vidal-Cortés P, Merino E, Calderón J, Fortún J, Palacios-Baena ZR, Pemán J, Sanchis JR, Aguilar-Guisado M, Gudiol C, Ramos JC, Sánchez-Romero I, Martin-Davila P, López-Cortés LE, Salavert M, Ruiz-Camps I, Chumbita M, Aiello TF, Peyrony O, Puerta-Alcalde P, Soriano A, Marco F, Garcia-Vidal C. Safety and effectiveness of isavuconazole in real-life non-neutropenic patients. Int J Infect Dis 2024; 144:107070. [PMID: 38663477 DOI: 10.1016/j.ijid.2024.107070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVES Information is scarce on clinical experiences with non-neutropenic patients with invasive fungal infection (IFI) receiving isavuconazole. We aimed to report the safety and effectiveness of this drug as a first-line treatment or rescue in real life. METHODS A retrospective, observational multicentric study of non-neutropenic patients who received isavuconazole as an IFI treatment at 12 different university hospitals (January 2018-2022). All patients met criteria for proven, probable or possible IFI according to EORTC-MSG. RESULTS A total of 238 IFIs were treated with isavuconazole during the study period. Combination therapy was administered in 27.7% of cases. The primary IFI was aspergillosis (217, 91.2%). Other IFIs treated with isavuconazole were candidemia (n = 10), mucormycosis (n = 8), histoplasmosis (n = 2), cryptococcosis (n = 2), and others (n = 4). Median time of isavuconazole treatment was 29 days. Only 5.9% (n = 14) of cases developed toxicity, mainly hepatic-related (10 patients, 4.2%). Nine patients (3.8%) had treatment withdrawn. Successful clinical response at 12 weeks was documented in 50.5% of patients. CONCLUSION Isavuconazole is an adequate treatment for non-neutropenic patients with IFIs. Toxicity rates were low and its effectiveness was comparable to other antifungal therapies previously reported.
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Affiliation(s)
- Patricia Monzó-Gallo
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain
| | - Carlos Lopera
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain
| | - Ana M Badía-Tejero
- Department of Infectious Diseases, Hospital of Bellvitge, Barcelona, Spain
| | - Marina Machado
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid - Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Julio García-Rodríguez
- Infectious Diseases Unit, University Hospital La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; CIBER Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain
| | | | - Esperanza Merino
- Department of Infectious Diseases, Hospital General Universitario Dr. Balmis - Instituto, Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Jorge Calderón
- Department of Infectious Diseases, University Hospital Puerta de Hierro, Madrid, Spain
| | - Jesús Fortún
- Department of Infectious Diseases, University Hospital Ramon y Cajal, Madrid, Spain
| | - Zaira R Palacios-Baena
- Infectious Diseases and Microbiology Clinical Unit, University Hospital Virgen Macarena, Institute of Biomedicine of Seville (IBiS) and CSIC, Seville, Spain; CIBER Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain
| | - Javier Pemán
- Infectious Diseases Unit (Medical Clinical Department), University and Polytechnic Hospital La Fe, La Fe Health Research Institute (IIS-La Fe), Valencia, Spain
| | - Joan Roig Sanchis
- Department of Infectious Diseases, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Manuela Aguilar-Guisado
- Unit of Infectious Diseases, Microbiology and Parasitology, Virgen del Rocío University Hospital, Seville, Spain; CIBER Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain
| | - Carlota Gudiol
- Department of Infectious Diseases, Hospital of Bellvitge, Barcelona, Spain; CIBER Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain
| | - Juan C Ramos
- Infectious Diseases Unit, University Hospital La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; CIBER Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain
| | - Isabel Sánchez-Romero
- Department of Infectious Diseases, University Hospital Puerta de Hierro, Madrid, Spain
| | - Pilar Martin-Davila
- Department of Infectious Diseases, University Hospital Ramon y Cajal, Madrid, Spain
| | - Luis E López-Cortés
- Infectious Diseases and Microbiology Clinical Unit, University Hospital Virgen Macarena, Institute of Biomedicine of Seville (IBiS) and CSIC, Seville, Spain; CIBER Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain
| | - Miguel Salavert
- Infectious Diseases Unit (Medical Clinical Department), University and Polytechnic Hospital La Fe, La Fe Health Research Institute (IIS-La Fe), Valencia, Spain
| | - Isabel Ruiz-Camps
- Department of Infectious Diseases, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Mariana Chumbita
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain
| | - Tommaso Francesco Aiello
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain
| | - Olivier Peyrony
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain; Emergency Department, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pedro Puerta-Alcalde
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Alex Soriano
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain.; CIBER Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain
| | - Francesc Marco
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain.; Department of Microbiology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain.; CIBER Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain.
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Liu F, Shao X, Dong Z, Tang K, Zhong L, Xu W, Chen Z, Zheng C, Zhang K, Cai J, Zhou H, Cui W, Xie C, Zhang L, Zhang G. Clinical characteristics and prognostic risk factors of candidemia in non-neutropenic patients: a retrospective cohort study. Eur J Clin Microbiol Infect Dis 2023; 42:1389-1394. [PMID: 37792119 DOI: 10.1007/s10096-023-04672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 09/27/2023] [Indexed: 10/05/2023]
Abstract
This study aimed to determine the clinical characteristics and the prognostic risk factors in non-neutropenic patients with candidemia. Data were retrospectively collected through the medical record information system. Non-neutropenic patients with candidemia were relatively aged, with a more than one-third rate of in-hospitalization mortality. In multivariate analysis, APACHE II score (adjusted odds ratio [aOR], 1.138; 95% confidence interval [CI], 1.067-1.213), septic shock (aOR, 5.704; 95% CI, 2.639-12.326) and RRT (aOR, 16.152; 95% CI, 2.628-99.275) (all P < 0.01) were independent related with non-survivors. In conclusion, non-neutropenic patients with candidemia have a high in-hospitalization mortality, and APACHE II, septic shock, and RRT are independently factors.
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Affiliation(s)
- Fengqi Liu
- Department of Critical Care Medicine, the First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, 313000, Zhejiang, China
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Xueping Shao
- Department of Critical Care Medicine, the First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, 313000, Zhejiang, China
| | - Zhaohui Dong
- Department of Critical Care Medicine, the First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, 313000, Zhejiang, China
| | - Kankai Tang
- Department of Critical Care Medicine, the First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, 313000, Zhejiang, China
| | - Li Zhong
- Department of Critical Care Medicine, the First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, 313000, Zhejiang, China
| | - Wei Xu
- Department of Critical Care Medicine, the First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, 313000, Zhejiang, China
| | - Zhidong Chen
- Department of Critical Care Medicine, the First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou University, Huzhou, 313000, Zhejiang, China
| | - Cheng Zheng
- Department of Critical Care Medicine, Taizhou Municipal Hospital, Taizhou, 318000, Zhejiang, China
| | - Kai Zhang
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Jiachang Cai
- Clinical Microbiology Laboratory, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Hongwei Zhou
- Clinical Microbiology Laboratory, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Wei Cui
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Chuangao Xie
- Department of Gastroenterology, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
| | - Liangfeng Zhang
- Department of General Surgery, Huzhou Third Municipal Hospital, Affiliated With Huzhou University, Huzhou, 313000, Zhejiang, China.
| | - Gensheng Zhang
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China.
- Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
- Ministry of Education, Key Laboratory of Multiple Organ Failure (Zhejiang University), Hangzhou, 310009, China.
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Hase I, Kagatani J, Suzuki S, Yoshida S, Sakamoto K, Maitani F, Horinouchi H, Kamei K, Tateno H. Successfully treated bronchopulmonary oxalosis caused by Aspergillus tubingensis in a non-neutropenic patient: A case report and review of the literature. J Infect Chemother 2021; 28:299-303. [PMID: 34756827 DOI: 10.1016/j.jiac.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 11/17/2022]
Abstract
Pulmonary oxalosis can be fatal, and Aspergillus tubingensis is commonly resistant to azoles in Japan. We report a case of bronchopulmonary oxalosis caused by A. tubingensis in a non-neutropenic patient who was successfully treated with voriconazole monotherapy. The susceptibility of the isolates to voriconazole and the effective elimination of contagious necrotic tissue by expectoration seemed to be two major factors contributing to the patient's survival. According to the literature review, pulmonary oxalosis is associated with a high mortality rate over a short term. An exploration of detailed information about the genomic characteristics and drug susceptibility of Aspergillus isolates is important for the development of treatment strategies for this life-threatening disease.
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Affiliation(s)
- Isano Hase
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan.
| | - Jin Kagatani
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Shoji Suzuki
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Shuichi Yoshida
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Kei Sakamoto
- Department of General Thoracic Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Fumio Maitani
- Department of General Thoracic Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Hirohisa Horinouchi
- Department of General Thoracic Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Katsuhiko Kamei
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 60-8673, Japan
| | - Hiroki Tateno
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
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