Artikel
Fungiscope – a global registry for rare fungal infections
Fungiscope – ein globales Register für seltene Pilzinfektionen
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Autoren
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M.J. Rüping
- 1st Department of Internal Medicine, University of Cologne, Germany
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W.J. Heinz
- Medizinische Klinik und Poliklinik II, University Hospital Würzburg, Heidelberg, Germany
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A.J. Kindo
- Department of Microbiology, Sri Ramachandra University, Chennai, India
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A. Hamprecht
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Germany
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T. Krafczyk
- 1st Department of Internal Medicine, University of Cologne, Germany
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G. Fischer
- Landesgesundheitsamt Baden-Württemberg, Arbeitsmedizin, Umweltbezogener Gesundheitsschutz, Stuttgart, Germany
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S. de Hoog
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, Netherlands
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J.J. Vehreschild
- 1st Department of Internal Medicine, University of Cologne, Germany; 1st Department of Internal Medicine, BMBF 01KI0771, University of Cologne, Germany
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O.A. Cornely
- 1st Department of Internal Medicine, University of Cologne, Germany; Clinical Trials Centre Cologne, ZKS Köln, BMBF 01KN 0706, University of Cologne, Germany
| Veröffentlicht: | 2. Juni 2010 |
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Gliederung
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Objectives: We are coordinating a global registry for cases of rare invasive fungal diseases (IFD). Our objective is to broaden the knowledge on epidemiology, to determine the clinical pattern of disease, to describe and improve diagnostic procedures and therapeutic regimens, as well as to facilitate exchange of clinical isolates among the contributors.
Methods: Fungiscope™ – A Global Rare Fungal Infection Registry is an international university-based case registry that collects data of patients with rare IFD, using a web-based electronic case form at http://www.fungiscope.net/. For inclusion in the registry cases have to have positive cultures or histopathological, antigen or molecular genetic evidence of IFD and the associated clinical symptoms and signs of invasive infection. The data that are entered onto the registry include demographics, underlying conditions, neutrophil count, concomitant immunosuppressive medications, clinical signs and symptoms of IFD, site of infection, diagnostic tests performed, pathogen identification, antifungal treatment, surgical procedures performed, response to treatment, overall survival and attributable mortality.
Results: Overall, 140 cases have been completed. Results from 15 additional cases are pending. Chemotherapy or allogeneic stem cell transplantation for a haematological malignancy was the most predominant risk factor (n=53; 37.9%), as well as diabetes mellitus (n=40; 28.6%), chronic renal failure (n=17; 12%) and solid organ transplantation (n=14; 10%). In 49 patients (35 %) the lung was the organ of first diagnosis, followed by the sino-nasal region in 22 (15.7%) and deep soft tissue infections in 20 (14.3%) patients. For 75 (53.6%) patients, a favourable outcome, defined as a complete or partial response to treatment of IFD was documented. Overall mortality and mortality attributable to IFD was 36.4% (n=51) and 22.1% (n=31), respectively.
Conclusion: The clinical relevance of rare IFD is increasing steadily. In a short period of time, a wide varietyof cases from Europe, Asia and South America could be documented. Further investigators and coordinators are cordially invited to contribute to Fungiscope.
