Aspergilosis invasora en el paciente con enfermedad oncohematológica

Solano, Carlos; Vázquez, Lourdes

doi:10.1016/j.riam.2018.10.001

Cited by 3 publications

(8 citation statements)

References 65 publications

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“…However, there are other species of Aspergillus spp. that cause infection, such as A. flavus, A. niger, A. terreus, A. nidulans, and A. lentulus, which are becoming increasingly common, depending on geographical factors, host type, and antifungal prophylaxis used [3,5].…”

Section: Introductionmentioning

confidence: 99%

“…People with HM are the most susceptible group to suffer from IFI, both in the adult and pediatric population. Specifically, invasive aspergillosis (IA) is the most common invasive fungal infection in patients with acute hematologic malignancies [5]. Multiple risk factors are involved in the development of IA in patients with HM [6].…”

Section: Introductionmentioning

confidence: 99%

“…Multiple risk factors are involved in the development of IA in patients with HM [6]. Many of them are related to the characteristics of the patients, such as: (i) neutrophils < 500 per mm 3 and neutropenia time greater than 10 days [7], (ii) being older than 65 years [4,5], (iii) genetic polymorphisms associated with the immune response [5][6][7][8], (iv) type of neoplastic disease and its progression [9], (v) CD4 T lymphocytes < 200 per mm 3 [3] and (vi) previous infections [4,6,[10][11][12]. A history of repeated blood transfusions [13], the use of corticosteroids [14], intensive chemotherapy regimens with radiotherapy [15], and the use of new therapeutic strategies, such as biologic agents [16][17][18], increase the risk of IA in patients with HM.…”

Section: Introductionmentioning

confidence: 99%

“…Environmental risk factors are related to an increase in the number of conidia per cubic meter [1][2][3][4][5]24]. These can be produced naturally through seasonal changes or exposure to plant products, or artificially produced due to the proximity of construction areas, including in the hospital itself, or due to the lack of adequate insulation in the rooms of patients with HM, such as: (i) the inadequate insulation of doors and windows, (ii) a lack of High Efficiency Particulate Air (HEPA) filters, (iii) no laminar air flow (LAF), (iv) no positive differential pressure, and (v) a low number of air renewals.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies

Raposo Puglia,

García-Cabrera

et al. 2024

Clinics and Practice

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(1) Background: Aspergillus spp. is a widely distributed filamentous fungus in the environment due to its high sporulation capacity. Currently, invasive aspergillosis (IA) is the most common invasive fungal infection in patients with hematologic malignancies, with high rates of mortality and morbidity. The multifactorial nature of the disease requires appropriate risk stratification to enable the most appropriate preventive measures to be adapted and implemented according to the characteristics of the patient. In this sense, the present research aims to identify recent risk factors and environmental control measures against invasive aspergillosis to establish preventive actions to reduce the incidence of invasive aspergillosis in hospitals. (2) Methods: We conducted a qualitative systematic review of the scientific literature on environmental risk factors and preventive measures for invasive aspergillosis in patients with hematologic malignancies. The Medline, Cochrane, and Scopus databases were consulted, following the PRISMA and STROBE guidelines. (3) Results: Adequate implementation of environmental control measures is presented as the most efficient intervention in terms of prevention to decrease the incidence of invasive aspergillosis in hospitals. Neutropenia, fungal contamination, insufficient environmental control measures in hospital and home settings, length of hospital stay, and anemia, are identified as independent risk factors. We show that HEPA, LAF, and Plasmair® systems are suitable methods to reduce the concentration of airborne fungal spores. Antifungal prophylaxis did not significantly influence IA reduction in our study. (4) Conclusions: Proper professional training and environmental control measures in hospitals are essential for the prevention of invasive aspergillosis. We should optimize risk stratification for patients with hematologic malignancies. Antifungal prophylaxis should be complementary to environmental control measures and should never be substituted for the latter. Studies should also be undertaken to evaluate the efficiency of environmental control measures against IA at patients’ homes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies

Raposo Puglia,

García-Cabrera

et al. 2024

Clinics and Practice

View full text Add to dashboard Cite

show abstract

“…However, there are other species of Aspergillus spp. that cause infection, such as A. flavus, A. niger, A. terreus, A. nidulans and A. lentulus, that are becoming increasingly common, depending on geographical factors, host type and antifungal prophylaxis used [3,5].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies

Raposo Puglia,

García-Cabrera

et al. 2023

Preprint

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Background Aspergillus spp. is a widely distributed filamentous fungus in the environment due to its high sporulation capacity. Currently, invasive aspergillosis (IA) is the most common invasive fungal infection in patients with hematologic malignancies with high rates of mortality and morbidity. The multifactorial nature of the disease requires appropriate risk stratification to allow the most appropriate preventive measures to be adapted and implemented according to the characteristics of the patient. In this sense, the present research aims to identify recent risk factors and environmental control measures against invasive aspergillosis to establish preventive actions to reduce the incidence of invasive aspergillosis in hospitals; (2) Methods: We conducted a qualitative systematic review of the scientific literature on environmental risk factors and preventive measures for invasive aspergillosis in patients with hematological malignancies. The Medline, Cochrane and Scopus databases were consulted, following the PRISMA and STROBE guidelines; (3) Results Adequate implementation of environmental control measures is presented as the most efficient intervention in terms of prevention to decrease the incidence of invasive aspergillosis in hospitals. We identify neutropenia, fungal contamination, lack of adequate environmental control measures in hospitals and patients´ homes, duration of hospitalization, and anemia as independent risk factors. We show that HEPA, LAF and Plasmair® systems are suitable methods to reduce the concentration of airborne fungal spores. Antifungal prophylaxis did not influence the reduction of IA significantly in our study; (4) Conclusions: Proper professional training and environmental control measures in hospitals are essential for the prevention of invasive aspergillosis. We should optimize risk stratification for patients with hematologic malignancies. Antifungal prophylaxis should be complementary to environmental control measures and should never be substituted for these last ones. Studies should also be done to evaluate the efficiency of environmental control measures against IA at patients' homes.

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Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

Liang

Han

et al. 2020

BMC Pulm Med

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Background Increasing cases of pulmonary aspergillosis (IPA) in immunocompetent patients with severe influenza have been reported. Howevere, the risk factors for occurence and death are largely unknown. Methods Data of hospitalised patients with influenza A-related pneumonia (FluA-p) obtained from five teaching hospitals from 2031 to 2018, were reviewed. Univariate and multivariate logistical regression analyses were performed to determine the risk factors involved in the acquisition and 60-day mortality in IPA patients. Results Of the 693 FluA-p patients included in the study, 3.0% (21/693) were IPA patients with a 60-day mortality of 42.9% (9/21). Adjusted for confounders, a Cox proportional hazard model showed that IPA was associated with increased risk for 60-day mortality [hazard ratio (HR) 4.336, 95% confidence interval (CI) 1.191–15.784, p = 0.026] in FluA-p patients. A multivariate logistic regression model confirmed that age (odd ratio (OR) 1.147, 95% CI 1.048–1.225, p = 0.003), systemic corticosteroids use before IPA diagnosis (OR 33.773, 95% CI 5.681–76.764, p < 0.001), leukocytes > 10 × 109/L (OR 1.988, 95% CI 1.028–6.454, p = 0.029) and lymphocytes < 0.8 × 109/L on admission (OR 34.813, 95% CI 1.676–73.006, p = 0.022), were related with the acquisition of IPA. Early neuraminidase inhibitor use (OR 0.290, 95% CI 0.002–0.584, p = 0.021) was associated with a decreased risk for a 60-day mortality in IPA patients. Conclusions Our results showed that IPA worsen the clinical outcomes of FluA-p patients. The risk factors for the acquisition and death were helpful for the clinicians in preventing and treating IPA.

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Aspergilosis invasora en el paciente con enfermedad oncohematológica

Cited by 3 publications

References 65 publications

Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies

Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies

Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies

Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

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