Prevalence of fungal DNAemia mediated by putatively non-pathogenic fungi in immunocompromised patients with febrile neutropenia: a prospective cohort study

LUCINI, Chantal, Klara OBROVA, Isabella KRICKL, Filomena NOGUEIRA, Iva KOCMANOVA, Susanne HERNDLHOFER, Karoline V GLEIXNER, Wolfgang R SPERR, Tijana FRANK, Nuno ANDRADE, Christina PETERS, Gernot ENGSTLER, Michael DWORZAK, Andishe ATTARBASCHI, Martine VAN GROTEL, Marry M VAN DEN HEUVEL-EIBRINK, Ivan S MOISEEV, Yuliya ROGACHEVA, Ludmilla ZUBAROVSKAYA, Natalia ZUBAROVSKAYA, Herbert PICHLER, Anita LAWITSCHKA, Elisabeth KOLLER, Felix KEIL, Jiří MAYER, Barbora WEINBERGEROVÁ, Peter VALENT a Thomas LION. Prevalence of fungal DNAemia mediated by putatively non-pathogenic fungi in immunocompromised patients with febrile neutropenia: a prospective cohort study. JOURNAL OF HEMATOLOGY & ONCOLOGY. LONDON: BMC, 2024, roč. 17, č. 1, s. 1-6. ISSN 1756-8722. Dostupné z: https://dx.doi.org/10.1186/s13045-024-01583-0.

Základní údaje

• Originální název: Prevalence of fungal DNAemia mediated by putatively non-pathogenic fungi in immunocompromised patients with febrile neutropenia: a prospective cohort study
• Autoři: LUCINI, Chantal, Klara OBROVA, Isabella KRICKL, Filomena NOGUEIRA, Iva KOCMANOVA, Susanne HERNDLHOFER, Karoline V GLEIXNER, Wolfgang R SPERR, Tijana FRANK, Nuno ANDRADE, Christina PETERS, Gernot ENGSTLER, Michael DWORZAK, Andishe ATTARBASCHI, Martine VAN GROTEL, Marry M VAN DEN HEUVEL-EIBRINK, Ivan S MOISEEV, Yuliya ROGACHEVA, Ludmilla ZUBAROVSKAYA, Natalia ZUBAROVSKAYA, Herbert PICHLER, Anita LAWITSCHKA, Elisabeth KOLLER, Felix KEIL, Jiří MAYER (203 Česká republika, domácí), Barbora WEINBERGEROVÁ (203 Česká republika, domácí), Peter VALENT a Thomas LION.
• Vydání: JOURNAL OF HEMATOLOGY & ONCOLOGY, LONDON, BMC, 2024, 1756-8722.

Další údaje

• Originální jazyk: angličtina
• Typ výsledku: Článek v odborném periodiku
• Obor: 30205 Hematology
• Stát vydavatele: Velká Británie a Severní Irsko
• Utajení: není předmětem státního či obchodního tajemství
• WWW: URL
• Impakt faktor: Impact factor: 28.500 v roce 2022
• Organizační jednotka: Lékařská fakulta
• Doi: http://dx.doi.org/10.1186/s13045-024-01583-0
• UT WoS: 001286342300001
• Klíčová slova anglicky: Invasive fungal disease; panfungal-PCR; Fungal diagnostic; Antifungal therapy; Antifungal treatment
• Štítky: 14110212, rivok
• Příznaky: Mezinárodní význam, Recenzováno

Anotace

Invasive fungal disease (IFD) presents a life-threatening condition in immunocompromised patients, thus often prompting empirical administration of antifungal treatment, without adequate mycological evidence. Over the past years, wide use of antifungal prophylaxis resulted in decreased occurrence of IFD but has contributed to changes in the spectrum of fungal pathogens, revealing the occurrence of previously rare fungal genera causing breakthrough infections. The expanding spectrum of clinically relevant fungal pathogens required the implementation of screening approaches permitting broad rather than targeted fungus detection to support timely onset of pre-emptive antifungal treatment. To address this diagnostically important aspect in a prospective setting, we analyzed 935 serial peripheral blood (PB) samples from 195 pediatric and adult patients at high risk for IFD, involving individuals displaying febrile neutropenia during treatment of hematological malignancies or following allogeneic hematopoietic stem cell transplantation. Two different panfungal-PCR-screening methods combined with ensuing fungal genus identification by Sanger sequencing were employed. In the great majority of PB-specimens displaying fungal DNAemia, the findings were transient and revealed fungi commonly regarded as non-pathogenic or rarely pathogenic even in the highly immunocompromised patient setting. Hence, to adequately exploit the diagnostic potential of panfungal-PCR approaches for detecting IFD, particularly if caused by hitherto rarely observed fungal pathogens, it is necessary to confirm the findings by repeated testing and to identify the fungal genus present by ensuing analysis. If applied appropriately, panfungal-PCR-screening can help prevent unnecessary empirical therapy, and conversely, contribute to timely employment of effective pre-emptive antifungal treatment strategies.