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  4. Epidemiology and clinical characteristics of invasive mould infections: A multicenter, retrospective analysis in five Asian countries
 
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Epidemiology and clinical characteristics of invasive mould infections: A multicenter, retrospective analysis in five Asian countries

Journal
Medical mycology
Journal Volume
56
Journal Issue
2
Pages
186
Date Issued
2018-02-01
Author(s)
Rotjanapan, P
YEE-CHUN CHEN  
Chakrabarti A.
Rudramurthy, S M
JING YU  
HSIANG-CHI KUNG  
Watcharananan, S
Watcharananan S.
Saffari, S E
Saffari S.E.
YEE-CHUN CHEN
DOI
10.1093/mmy/myx029
URI
https://scholars.lib.ntu.edu.tw/handle/123456789/510056
URL
https://api.elsevier.com/content/abstract/scopus_id/85031744726
Abstract
Formal, large-scale, multicenter studies of invasive mould infection (IMI) in Asia are rare. This 1-year, retrospective study was designed to assess the incidence and clinical determinants of IMI in centers in five countries (Thailand, Taiwan, Singapore, China, India). Patients treated in a single year (2012) were identified through discharge diagnoses, microbiology, and histopathology logs, and entered based on published definitions of IMI. A total of 155 cases were included (median age 54 years; 47.7% male). Of these, 47.7% had proven disease; the remainder had probable IMI. The most frequent host factors were prolonged steroid use (39.4%) and recent neutropenia (38.7%). Common underlying conditions included diabetes mellitus (DM; 30.9%), acute myeloid leukemia (19.4%), and rheumatologic conditions (11.6%). DM was more common in patients with no recent history of neutropenia or prolonged steroid use (P = .006). The lung was the most frequently involved site (78.7%), demonstrating a range of features on computed tomography (CT). Aspergillus was the most common mould cultured (71.6%), primarily A. fumigatus and A. flavus, although proportions varied in different centers. The most often used antifungal for empiric therapy was conventional amphotericin. Ninety-day mortality was 32.9%. This is the first multicenter Asian study of IMI not limited to specific patient groups or diagnostic methods. It suggests that DM and rheumatologic conditions be considered as risk factors for IMI and demonstrates that IMI should not be ruled out in patients whose chest features on CT do not fit the conventional criteria.
Subjects
diabetes mellitus; invasive aspergillosis; invasive mould disease
SDGs

[SDGs]SDG3

Other Subjects
amphotericin; amphotericin B deoxycholate; corticosteroid; echinocandin; fluconazole; immunomodulating agent; iron chelating agent; itraconazole; posaconazole; voriconazole; amphotericin B; antifungal agent; acute myeloid leukemia; adolescent; adult; aged; antifungal therapy; Article; Aspergillus; Aspergillus flavus; Aspergillus fumigatus; child; China; clinical feature; diabetes mellitus; female; fungus culture; human; incidence; India; infection risk; invasive aspergillosis; lung; lung biopsy; major clinical study; male; medical history; mortality; neutropenia; nonhuman; retrospective study; rheumatic disease; Singapore; Taiwan; Thailand; treatment duration; treatment outcome; very elderly; x-ray computed tomography; Asia; clinical trial; diagnostic imaging; fungus; incidence; microbiology; middle aged; multicenter study; physiology; preschool child; risk factor; systemic mycosis; young adult; Adolescent; Adult; Aged; Aged, 80 and over; Amphotericin B; Antifungal Agents; Asia; Aspergillus; Child; Child, Preschool; Female; Fungi; Humans; Incidence; Invasive Fungal Infections; Lung; Male; Middle Aged; Retrospective Studies; Risk Factors; Treatment Outcome; Young Adult
Publisher
OXFORD UNIV PRESS
Type
journal article

臺大位居世界頂尖大學之列,為永久珍藏及向國際展現本校豐碩的研究成果及學術能量,圖書館整合機構典藏(NTUR)與學術庫(AH)不同功能平台,成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。

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