Mucormycosis in intensive care unit: surgery ...
Type de document :
Article dans une revue scientifique
URL permanente :
Titre :
Mucormycosis in intensive care unit: surgery is a major prognostic factor in patients with hematological malignancy
Auteur(s) :
Claustre, Johanna [Auteur]
Centre de Recherche en Transplantation et Immunologie [U1064 Inserm - CRTI]
Larcher, Romaric [Auteur]
CHU Montpellier
Jouve, Thomas [Auteur]
Service de néphrologie, dialyse, aphérèses et transplantation
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Truche, Anne-Sophie [Auteur]
Service de Réanimation Médicale [Grenoble]
Nseir, Saad [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Cadiet, Julien [Auteur]
Centre Hospitalier Universitaire de Nantes [CHU Nantes]
Zerbib, Yoann [Auteur]
CHU Amiens-Picardie
Lautrette, Alexandre [Auteur]
CHU Clermont-Ferrand
Constantin, Jean-Michel [Auteur]
CHU Clermont-Ferrand
Charles, Pierre-Emmanuel [Auteur]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Daubin, Cedric [Auteur]
Service de réanimation médicale [CHU Caen]
Coudroy, Remi [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers]
Dellamonica, Jean [Auteur]
CHU Nice [Cimiez]
Argaud, Laurent [Auteur]
CIC CHU Lyon (inserm)
Phelouzat, Pierre [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Contou, Damien [Auteur]
Service de réanimation médicale
Pocquet, Juliette [Auteur]
CHU Trousseau [Tours]
Voiriot, Guillaume [Auteur]
Navellou, Jean-Christophe [Auteur]
Lavagne, Pierre [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Durand, Michel [Auteur]
Service de réanimation cardio-vasculaire et thoracique
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Cornet, Muriel [Auteur]
Laboratoire de parasitologie-mycologie
Schwebel, Carole [Auteur]
Service de Réanimation Médicale [Grenoble]
Terzi, Nicolas [Auteur]
Service de Réanimation Médicale [Grenoble]
Centre de Recherche en Transplantation et Immunologie [U1064 Inserm - CRTI]
Larcher, Romaric [Auteur]
CHU Montpellier
Jouve, Thomas [Auteur]
Service de néphrologie, dialyse, aphérèses et transplantation
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Truche, Anne-Sophie [Auteur]
Service de Réanimation Médicale [Grenoble]
Nseir, Saad [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Cadiet, Julien [Auteur]
Centre Hospitalier Universitaire de Nantes [CHU Nantes]
Zerbib, Yoann [Auteur]
CHU Amiens-Picardie
Lautrette, Alexandre [Auteur]
CHU Clermont-Ferrand
Constantin, Jean-Michel [Auteur]
CHU Clermont-Ferrand
Charles, Pierre-Emmanuel [Auteur]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Daubin, Cedric [Auteur]
Service de réanimation médicale [CHU Caen]
Coudroy, Remi [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers]
Dellamonica, Jean [Auteur]
CHU Nice [Cimiez]
Argaud, Laurent [Auteur]
CIC CHU Lyon (inserm)
Phelouzat, Pierre [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Contou, Damien [Auteur]
Service de réanimation médicale
Pocquet, Juliette [Auteur]
CHU Trousseau [Tours]
Voiriot, Guillaume [Auteur]
Navellou, Jean-Christophe [Auteur]
Lavagne, Pierre [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Durand, Michel [Auteur]
Service de réanimation cardio-vasculaire et thoracique
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Cornet, Muriel [Auteur]
Laboratoire de parasitologie-mycologie
Schwebel, Carole [Auteur]
Service de Réanimation Médicale [Grenoble]
Terzi, Nicolas [Auteur]
Service de Réanimation Médicale [Grenoble]
Titre de la revue :
Annals of Intensive Care
Nom court de la revue :
Ann. Intensive Care
Numéro :
10
Éditeur :
Springer Science and Business Media LLC
Date de publication :
2020-06-08
ISSN :
2110-5820
Mot(s)-clé(s) en anglais :
Mucormycosis
Hematological malignancy
Intensive care unit
Surgery
Prognostic factors
Hematological malignancy
Intensive care unit
Surgery
Prognostic factors
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Background :
Mucormycosis is an invasive fungal infection, with an increasing incidence especially in patients with hematological malignancies. Its prognosis is poor because of its high invasive power and its intrinsic ...
Lire la suite >Background : Mucormycosis is an invasive fungal infection, with an increasing incidence especially in patients with hematological malignancies. Its prognosis is poor because of its high invasive power and its intrinsic low susceptibility to antifungal agents. We aimed to describe the epidemiology of mucormycosis in intensive care units (ICU) and evaluate the outcomes. We performed a retrospective multi-center study in 16 French ICUs between 2008 and 2017. We compared the patients who survived in ICU and the patients who did not to identify factors associated with ICU survival. Then, we focused on the subgroup of patients with hematological malignancies. Results : Mucormycosis was diagnosed in 74 patients during the study period. Among them, 60 patients (81%) were immunocompromised: 41 had hematological malignancies, 9 were solid organ transplant recipients, 31 received long-term steroids, 11 had diabetes, 24 had malnutrition. Only 21 patients survived to ICU stay (28.4%) with a median survival of 22 days (Q1–Q3 = 9–106) and a survival rate at day 28 and day 90, respectively, of 35.1% and 26.4%. Survivors were significantly younger (p = 0.001), with less frequently hematological malignancies (p = 0.02), and less malnutrition (p = 0.05). Median survival in patients with hematological malignancies (n = 41) was 15 days (Q1–Q3 = 5–23.5 days). In this subgroup, curative surgery was a major factor associated with survival in multivariate analysis (odds ratio = 0.71, [0.45–0.97], p < 0.001). Conclusion : Overall prognosis of mucormycosis in ICU remains poor, especially in patients with hematological malignancies. In this subgroup of patients, a therapeutic strategy including curative surgery was the main factor associated with survival.Lire moins >
Lire la suite >Background : Mucormycosis is an invasive fungal infection, with an increasing incidence especially in patients with hematological malignancies. Its prognosis is poor because of its high invasive power and its intrinsic low susceptibility to antifungal agents. We aimed to describe the epidemiology of mucormycosis in intensive care units (ICU) and evaluate the outcomes. We performed a retrospective multi-center study in 16 French ICUs between 2008 and 2017. We compared the patients who survived in ICU and the patients who did not to identify factors associated with ICU survival. Then, we focused on the subgroup of patients with hematological malignancies. Results : Mucormycosis was diagnosed in 74 patients during the study period. Among them, 60 patients (81%) were immunocompromised: 41 had hematological malignancies, 9 were solid organ transplant recipients, 31 received long-term steroids, 11 had diabetes, 24 had malnutrition. Only 21 patients survived to ICU stay (28.4%) with a median survival of 22 days (Q1–Q3 = 9–106) and a survival rate at day 28 and day 90, respectively, of 35.1% and 26.4%. Survivors were significantly younger (p = 0.001), with less frequently hematological malignancies (p = 0.02), and less malnutrition (p = 0.05). Median survival in patients with hematological malignancies (n = 41) was 15 days (Q1–Q3 = 5–23.5 days). In this subgroup, curative surgery was a major factor associated with survival in multivariate analysis (odds ratio = 0.71, [0.45–0.97], p < 0.001). Conclusion : Overall prognosis of mucormycosis in ICU remains poor, especially in patients with hematological malignancies. In this subgroup of patients, a therapeutic strategy including curative surgery was the main factor associated with survival.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
Université de Lille
CNRS
CNRS
Équipe(s) de recherche :
Glycobiology in fungal Pathogenesis and Clinical Applications
Date de dépôt :
2021-07-15T09:11:24Z
2021-08-25T09:24:27Z
2021-08-25T09:24:27Z
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