J 2024

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 et. al.

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

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

Odkazy

Impakt faktor

Impact factor: 28.500 v roce 2022

Organizační jednotka

Lékařská fakulta

UT WoS

001286342300001

Klíčová slova anglicky

Invasive fungal disease; panfungal-PCR; Fungal diagnostic; Antifungal therapy; Antifungal treatment

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 20. 8. 2024 10:23, Mgr. Tereza Miškechová

Anotace

V originále

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.