Evidence-Based Guidelines for Empirical Therapy of Neutropenic Fever in Korea

Lee, Dong Gun; Kim, Sung-Han; Kim, Soo Young; Kim, Chung Jong; Park, Wan Beom; Song, Young Goo; Choi, Jung Hyun

doi:10.3904/kjim.2011.26.2.220

Cited by 76 publications

(71 citation statements)

References 202 publications

(254 reference statements)

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“…In fact, hematopoietic stem cell transplantation is a curative therapy to hematological malignancy. Hematological malignancy patients and hematopoietic stem cell transplant recipients are high-risk patients who are prone to getting causative agent infection, especially, increasing the risk from latent to active TB (Lee et al, 2011). Nearly one third of the world's population is infected with mycobacterium tuberculosis (Dolin et al, 1994), and the rate continues to increase.…”

Section: Introductionmentioning

confidence: 99%

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Qin¹,

Wang²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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The diagnosis of latent Mycobacterium tuberculosis infection (LTBI) is recommended in hematological malignancy patients and before hematopoietic stem cell transplantation (Guidelines for the prevention and management of infectious complications of solid organ transplantation, 2004). Compared to traditional methods such as tuberculin skin test (TST), T-SPOT.TB has been shown to be more specific. In the present study we enrolled 536 patients for whom T-SPOT.TB was performed, among which 295 patients also received the TST test. The agreement (79%) between T-SPOT.TB and TST was poor (κ=0.274, P<0.001). The patients with positive T-SPOT.TB results numbered 62 (11.6%), in which only 20 (48.8%) of the 41 receiving the TST test had positive results. A majority of the patients with T-SPOT.TB positive results had some other evidence ofTB, such as TB history, clinical symptoms and an abnormal chest CT scan. Active TB was found in 9 patients, in which 2 had negative TST results. We followed up the patients and no one developed active TB. Our study suggested that the T-SPOT.TB may be more useful for screening LTBI and active TB in hematological malignancy patients and hematopoietic stem cell transplant recipients than the TST test.

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Section: Introductionmentioning

confidence: 99%

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Qin¹,

Wang²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…In two other studies conducted in Malaysia and Pakistan the same trend was observed (2,11). Dong-Gun Lee et al (12) mentioned that as a general characteristic of Asia-Pacific region, Gramnegative microorganisms were the major pathogens of infection.…”

Section: Introductionmentioning

confidence: 99%

A Population-Based Study of Bacterial Spectrum in Febrile Neutropenic Patients

Meidani

Bagheri

Khorvash

2013

Jundishapur J Microbiol

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Background: Because of great concerns about mortality and morbidity of infection in febrile neutropenic patients, the appropriate empirical antibiotic should be started immediately. Although there are established guidelines for the use of empirical therapy, local microbiological pattern and antibiotic susceptibility should be considered. Objectives: The current study aimed to identify the etiological pathogens in febrile neutropenic cancer patients in Isfahan, Iran. Patients and Methods:This single-centre population-based study was conducted on 81 febrile neutropenic patients referring to Sayed-AlShohada hospital, the only referral malignant care center in Isfahan, Iran. Demographic data, duration and kind of malignancy, duration from last chemotherapy, duration of fever, and also physical exam were recorded for each patient. Moreover, procalcitonin, CRP, ESR, white blood cells, hemoglobin, platelet, and absolute neutrophil count were measured. BACTEC and E-test were used for blood culturing and determining the antibiotic susceptibility. Results: Out of 81 participants, 28.4% had positive blood cultures which mostly consisted of Gram-positive microorganisms. In addition, Staphylococcus epidermidis was the most isolated Gram positive bacteria (39.1%). ESR, CRP, and procalcitonin were significantly higher in patients with positive blood culture. The risk of infection increased with raise in duration of hospital stay, catheterization, increased pulse rate, increased oral temperature, low level of oxygen saturation, decreased systolic blood pressure, and low absolute neutrophile count. However, in this case, no relationship was found among the patients' age, diastolic blood pressure, respiratory rate, duration of diagnosis, duration from last chemotherapy, duration of fever, white blood cells, hemoglobin, platelet, and finally the type of malignancies. Conclusions: It was concluded that Gram-positive bacteria were more prevalent as a cause of infection in the patients with malignancy and the most common pathogen was S. epidermidis. Larger studies are needed to determine the bacterial susceptibility of this center.

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“…The prevalence of mucormycosis, in particular, has been increasing along with the increasing use of antifungal agents with anti-Aspergillus activity, such as voriconazole [2,3] and it is the third most common fungal infection after candidiasis and aspergillosis [4]. In addition, because voriconazole has no activity in mucormycosis but results in better survival of patients with invasive pulmonary aspergillosis (IPA) than amphotericin B [5,6], distinguishing between IPA and pulmonary mucormycosis (PM) is important clinically. Although definite diagnoses can be made by combining histomorphologic diagnosis with fungal culture results, cultures are often negative, especially for mucormycosis [1].…”

mentioning

confidence: 99%

Assessment of the accuracy of histomorphologic diagnosis of aspergillosis and mucormycosis by immunohistochemical tests

Jung¹,

Park²,

Sung

et al. 2015

Clin Infect Dis.

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Background. Data on the accuracy of conventional histomorphologic diagnosis are limited, especially in mucormycosis. We therefore investigated the accuracy of histomorphologic diagnosis of mucormycosis and aspergillosis, using immunohistochemistry (IHC) tests for mucormycosis and aspergillosis.Methods. Patients enrolled met the modified criteria for proven and probable mucormycosis (during a 22-year period) or invasive aspergillosis (during a 6-year period) and had formalin-fixed, paraffin-embedded tissues available. We first tested the diagnostic performance of IHC for mucormycosis and aspergillosis in proven cases. Then we determined the accuracy of histomorphologic diagnosis of probable cases, using the IHC tests.Results. In 7 proven cases of mucormycosis, the sensitivity and specificity of mucormycosis IHC were 100% (95% confidence interval, 65%-100%) and 100% (68%-100%), respectively. In 8 proven cases of aspergillosis, and the sensitivity and specificity of aspergillosis IHC staining were 87% (53%-98%) and 100% (65%-100%), respectively. Of 23 probable mucormycosis cases, 20 (87%) were positive with mucormycosis IHC, 2 (9%) were positive with aspergillosis IHC (including 1 positive for both), and 2 were negative with both. Of 16 probable aspergillosis cases, 10 (63%) were positive with aspergillosis IHC, 4 (25%) were positive with mucormycosis IHC, and 2 (13%) were negative with both tests.Conclusions. Aspergillosis and mucormycosis seem not to be correctly diagnosed morphologically, because some of the probable cases showed either test with both antibodies or failure to stain with the homologous antibody. In the absence of fungal culture results, the IHC tests seem helpful in differentiating between aspergillosis and mucormycosis.

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Evidence-Based Guidelines for Empirical Therapy of Neutropenic Fever in Korea

Cited by 76 publications

References 202 publications

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

A Population-Based Study of Bacterial Spectrum in Febrile Neutropenic Patients

Assessment of the accuracy of histomorphologic diagnosis of aspergillosis and mucormycosis by immunohistochemical tests

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