gms | German Medical Science

Objectives: The aim of this study is to determine the distiribution of invasive fungal diseases (IFD) types, risk factors and applied treatments at our hospital in the previous year.

Materials and Methods: Thirty-nine invasive fungal disease patients were enrolled in our study between 1st December 2012 to 15th November 2013. Examination and classification of each case was defined by the consensus guideline of European Organization for Research and Treatment of Cancer / Mycoses Study Group (EORTC/MSG). All patients were observed during hospitalization and if necassary after discharged.

Results: Two-thirds of patients were female. The mean age of patients (ranging from 22 to 88 years) were 62 years. Twenty-eight (72.7%) were proven, nine (23%) were probable, two (5.1%) were possible. Underlying diseases, in order of frequency, were as follows: Twenty of the 39 patients (51.2%) had malignancy (eight gynecological, seven hematologic, four solid organ, one mesenchymal), eight patients (20.5%) were solid organ transplant recipients (three kidney, three liver, two heart), three (7.6%) were chronic renal failure patients, two patients (5.1%) had rheumatoid arthritis, six patients (15.3%) had other kinds of underlying diseases. Candidemia was the most common and pulmonary aspergillosis was the second common types of infection. All types were shown in Figure 1 [Fig. 1]. Out of 23 candidemia 14 (60.8%) case were non-albicans spp. with a predominace of 9 (39.1%) C. glabrata. All the patients had history of prior hospitalization with a mean of 30.6 days. Twenty patients (51.2%) have stayed in intensive care with a mean of 19 days. Twenty-eight patients (71.7%) have recieved immunosuppressive or chemotherapeutic drugs, 35 patients (89.7%) have recieved antibiotic treatment before IFD. Galactomannan antigen positivity was determined in 8 of 11 pulmonary aspergillosis patient and 3 of them were not neutropenic. Caspofungin was the most commonly used antifungal drug to treat candidemia episodes and voriconazole was the most commonly used antifungal drug to treat pulmonary aspergillosis. Overall mortality rate of 39 patients was 43.5%.

Conclusions: This study has shown risk factors to be significantly associated with the development of IFD in adults. Candidemia and pulmonary aspergillosis were the most common IFD in our hospital as in all the world. Despite appropriate follow-up and antifungal therapy, IFD treatment is difficult to achieve success.