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dc.contributor.author | Puerta-Alcalde, Pedro | |
dc.contributor.author | Monzó-Gallo, Patricia | |
dc.contributor.author | Aguilar-Guisado, Manuela | |
dc.contributor.author | Ramos, Juan Carlos | |
dc.contributor.author | Laporte-Amargós, Júlia | |
dc.contributor.author | Machado, Marina | |
dc.contributor.author | Martin-Davila, Pilar | |
dc.contributor.author | Franch-Sarto, Mireia | |
dc.contributor.author | Sánchez-Romero, Isabel | |
dc.contributor.author | Badiola, Jon | |
dc.contributor.author | Gómez, Lucia | |
dc.contributor.author | Ruiz-Camps, Isabel | |
dc.contributor.author | Yáñez, Lucrecia | |
dc.contributor.author | Vázquez, Lourdes | |
dc.contributor.author | Chumbita, Mariana | |
dc.contributor.author | Marco, Francesc | |
dc.contributor.author | Soriano, Alex | |
dc.contributor.author | González, Pedro | |
dc.contributor.author | Fernández-Cruz, Ana | |
dc.contributor.author | Batlle, Montserrat | |
dc.contributor.author | Fortún, Jesús | |
dc.contributor.author | Guinea, Jesús | |
dc.contributor.author | Gudiol, Carlota | |
dc.contributor.author | García, Julio | |
dc.contributor.author | Ruiz Pérez de Pipaón, Maite | |
dc.contributor.author | Alastruey-Izquierdo, Ana | |
dc.contributor.author | Garcia-Vidal, Carolina | |
dc.date.accessioned | 2023-06-14T07:49:31Z | |
dc.date.available | 2023-06-14T07:49:31Z | |
dc.date.issued | 2023-07 | |
dc.identifier.citation | J Infect. 2023 Jul;87(1):46-53. | es_ES |
dc.identifier.uri | http://hdl.handle.net/20.500.12105/16163 | |
dc.description.abstract | Objectives: We describe the current epidemiology, causes, and outcomes of breakthrough invasive fungal infections (BtIFI) in patients with haematologic malignancies. Methods: BtIFI in patients with ≥ 7 days of prior antifungals were prospectively diagnosed (36 months across 13 Spanish hospitals) according to revised EORTC/MSG definitions. Results: 121 episodes of BtIFI were documented, of which 41 (33.9%) were proven; 53 (43.8%), probable; and 27 (22.3%), possible. The most frequent prior antifungals included posaconazole (32.2%), echinocandins (28.9%) and fluconazole (24.8%)-mainly for primary prophylaxis (81%). The most common haematologic malignancy was acute leukaemia (64.5%), and 59 (48.8%) patients had undergone a hematopoietic stem-cell transplantation. Invasive aspergillosis, principally caused by non-fumigatus Aspergillus, was the most frequent BtIFI with 55 (45.5%) episodes recorded, followed by candidemia (23, 19%), mucormycosis (7, 5.8%), other moulds (6, 5%) and other yeasts (5, 4.1%). Azole resistance/non-susceptibility was commonly found. Prior antifungal therapy widely determined BtIFI epidemiology. The most common cause of BtIFI in proven and probable cases was the lack of activity of the prior antifungal (63, 67.0%). At diagnosis, antifungal therapy was mostly changed (90.9%), mainly to liposomal amphotericin-B (48.8%). Overall, 100-day mortality was 47.1%; BtIFI was either the cause or an essential contributing factor to death in 61.4% of cases. Conclusions: BtIFI are mainly caused by non-fumigatus Aspergillus, non-albicans Candida, Mucorales and other rare species of mould and yeast. Prior antifungals determine the epidemiology of BtIFI. The exceedingly high mortality due to BtIFI warrants an aggressive diagnostic approach and early initiation of broad-spectrum antifungals different than those previously used. | es_ES |
dc.description.sponsorship | This work was funded by a grant from Gilead Sciences. P.P.-A. (JR20/00012, PI21/00498, and ICI21/00103) and C.G.-V. (FIS PI21/01640 and ICI21/00103) have received research grants funded by Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union. The funders had neither a specific role in study design or collection of data, nor in writing of the paper or decision to submit. | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Elsevier | es_ES |
dc.type.hasVersion | VoR | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
dc.subject | Antifungal | es_ES |
dc.subject | Breakthrough | es_ES |
dc.subject | Fungal disease | es_ES |
dc.subject | Invasive fungal infection | es_ES |
dc.subject | Mortality | es_ES |
dc.subject.mesh | Invasive Fungal Infections | es_ES |
dc.subject.mesh | Hematologic Neoplasms | es_ES |
dc.subject.mesh | Candidemia | es_ES |
dc.subject.mesh | Humans | es_ES |
dc.subject.mesh | Antifungal Agents | es_ES |
dc.subject.mesh | Prospective Studies | es_ES |
dc.subject.mesh | Fungi | es_ES |
dc.subject.mesh | Aspergillus | es_ES |
dc.title | Breakthrough invasive fungal infection among patients with haematologic malignancies: A national, prospective, and multicentre study | es_ES |
dc.type | journal article | es_ES |
dc.rights.license | Atribución 4.0 Internacional | * |
dc.identifier.pubmedID | 37201859 | es_ES |
dc.format.volume | 87 | es_ES |
dc.format.number | 1 | es_ES |
dc.format.page | 46-53 | es_ES |
dc.identifier.doi | 10.1016/j.jinf.2023.05.005 | es_ES |
dc.contributor.funder | Gilead Sciences (Spain) | es_ES |
dc.contributor.funder | Instituto de Salud Carlos III | es_ES |
dc.contributor.funder | Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) | es_ES |
dc.description.peerreviewed | Sí | es_ES |
dc.identifier.e-issn | 1532-2742 | es_ES |
dc.relation.publisherversion | https://doi.org/10.1016/j.jinf.2023.05.005 | es_ES |
dc.identifier.journal | The Journal of infection | es_ES |
dc.repisalud.centro | ISCIII::Centro Nacional de Microbiología | es_ES |
dc.repisalud.institucion | ISCIII | es_ES |
dc.rights.accessRights | open access | es_ES |
dc.relation.projectFIS | info:fis/Instituto de Salud Carlos III///PI21 - Proyectos de investigacion en salud (AES 2021). Modalidad proyectos de investigación en salud. (2021)/PI21/01640 | es_ES |
dc.relation.projectFIS | info:fis/Instituto de Salud Carlos III///Proyectos de investigación clínica independiente (2021) (2021)/ICI21/00103 | es_ES |
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Este ítem aparece en la(s) siguiente(s) colección(ones)
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IDIVAL - Instituto de Investigación Marqués de Valdecilla (Cantabria)
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IDIBAPS - Instituto de Investigaciones Biomédicas August Pi i Sunyer (Cataluña)
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Centro Nacional de Microbiología (CNM)
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IBIS - Instituto de Biomedicina de Sevilla (Andalucía)
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IDIBELL - Instituto de Investigación Biomédica de Bellvitge (Cataluña)
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IiSGM - Instituto de Investigación Sanitaria Gregorio Marañón (Madrid)