Epidemiology and sites of involvement of invasive fungal infections in patients with haematological malignancies: A 20-year autopsy study

Russell E. Lewis, Lizebeth Cahyame-Zuniga, Konstantinos Leventakos, Georgios Chamilos, Ronen Ben-Ami, Pheroze Tamboli, Jeffrey Tarrand, Gerald P. Bodey, Mario Luna, Dimitrios P. Kontoyiannis

Research output: Contribution to journalArticle

139 Scopus citations

Abstract

Autopsy studies remain an essential tool for understanding the patterns of fungal disease not detected ante mortem with current diagnostic approaches. We collected data concerning the microbiological trends, patient clinical characteristics and sites of involvement for invasive fungal infections (IFIs) identified at autopsy in a single large cancer treatment centre over a 20-year period (1989-2008). The autopsy rate and IFI prevalence both declined significantly during the study period. The prevalence of Aspergillus spp. decreased significantly from the first 15 years of the study (from 0.12 to 0.14 cases per 100 autopsies to 0.07 in 2004-2008; P = 0.04), with only Mucorales accounting for a greater proportion of IFIs over the duration of the study period (0.06 to 0.2 cases per 100 autopsies, P = 0.04). After 2003, moulds accounted for the majority of infections identified at autopsy in the spleen, kidney, heart and gastrointestinal tract. Despite a trend of decreasing prevalence from 1989 to 2004, invasive candidiasis increased in prevalence during later periods 2004-2008 (0.02-0.05 per 100 autopsies) with decreasing kidney, heart and spleen involvement. Despite a declining autopsy rate, these data suggest a decreasing prevalence overall of IFIs with changing patterns of dissemination in patients with haematological malignancies.

Original languageEnglish (US)
Pages (from-to)638-645
Number of pages8
JournalMycoses
Volume56
Issue number6
DOIs
StatePublished - Nov 1 2013

Keywords

  • Aspergillosis
  • Candidemia
  • Epidemiology

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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    Lewis, R. E., Cahyame-Zuniga, L., Leventakos, K., Chamilos, G., Ben-Ami, R., Tamboli, P., Tarrand, J., Bodey, G. P., Luna, M., & Kontoyiannis, D. P. (2013). Epidemiology and sites of involvement of invasive fungal infections in patients with haematological malignancies: A 20-year autopsy study. Mycoses, 56(6), 638-645. https://doi.org/10.1111/myc.12081