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Breakthrough invasive mould infections in patients treated with caspofungin.
MedLine Citation:
PMID:  22227384     Owner:  NLM     Status:  Publisher    
OBJECTIVES: To describe and estimate the rate of breakthrough invasive mould diseases (IMD) in patients receiving caspofungin. METHODS: Retrospective, non-interventional study conducted in three University Hospitals. RESULTS: Nineteen breakthrough infections have been identified including 13 aspergillosis, 2 mucormycosis, a fusariosis, a Hormographiella aspergillata infection and 2 possible IMD. Cases were equally distributed between the centres. Fourteen patients had a haematologic malignancy, four were transplant recipients (allogeneic haematopoietic stem cells in three, liver in one) and one had hepatic cirrhosis. Caspofungin has been prescribed as prophylaxis (n = 3), empirical therapy (n = 9) or directed therapy for candidemia (n = 5) or aspergillosis (n = 2). Aspergillus galactomannan was positive in serum or in bronchoalveolar lavage fluid in 10 of the 13 aspergillosis. Median duration of caspofungin treatment before breakthrough IMD was 15 days. Nine patients died within twelve weeks. Rate of breakthrough IMD in onco-haematology patients has been estimated to 7.3% for all mould infections and to 4.2% when restricted to documented aspergillosis. CONCLUSIONS: Our data call for Aspergillus galactomannan monitoring and close clinical and radiological examination in case of persistence or recurrence of infection signs in high-risk patients receiving caspofungin.
Katy-Anna Phai Pang; Cendrine Godet; Arnaud Fekkar; Julie Scholler; Yasmine Nivoix; Valérie Letscher-Bru; Laurent Massias; Catherine Kauffmann-Lacroix; Antoine Elsendoorn; Madalina Uzunov; Annick Datry; Raoul Herbrecht
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-29
Journal Detail:
Title:  The Journal of infection     Volume:  -     ISSN:  1532-2742     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908424     Medline TA:  J Infect     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ltd.
Pôle d'Oncologie et d'Hématologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 Avenue Moliere, 67098 Strasbourg, France.
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