Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home

Indoor Air ◽  
2014 ◽  
Vol 24 (6) ◽  
pp. 652-661 ◽  
Author(s):  
S. Rocchi ◽  
G. Reboux ◽  
F. Larosa ◽  
E. Scherer ◽  
E. Daguindeau ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Invasive Aspergillosis ◽  
Immunocompromised Patients ◽  
At Home

scholarly journals Invasive Aspergillosis in the Intensive Care Unit

2007 ◽  
Vol 45 (2) ◽  
pp. 205-216 ◽  
Author(s):  
W. Meersseman ◽  
K. Lagrou ◽  
J. Maertens ◽  
E. V. Wijngaerden
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Invasive Aspergillosis

scholarly journals 1598. Clinical implications of azole-resistant vs. azole-susceptible invasive aspergillosis in hematological malignancy (CLARITY) – a multicenter study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S795-S796
Author(s):  
Danila Seidel ◽  
Oliver Cornely ◽  
Marouan Zarrouk ◽  
Philipp Koehler ◽  
Jacques F Meis ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Invasive Aspergillosis ◽  
Stress Responses ◽  
Hematological Malignancy ◽  
Clinical Implications ◽  
Azole Resistance ◽  
Research Support ◽  
Material Support ◽  
Travel Grant

Abstract Background Advances in the survival of patients with invasive aspergillosis (IA) are jeopardized by the emergence of azole resistance in Aspergillus fumigatus, which has been associated with high probability of azole treatment failure. The clinical implications of azole-resistant IA compared to azole-susceptible IA remain unclear. Thus, we seek to describe the epidemiology and to determine the efficacy of antifungal therapy in patients with documented azole-resistant IA compared to azole-susceptible IA in patients with hematological malignancy. Methods For proven and probable IA (EORTC/MSG 2019) caused by A. fumigatus in patients with hematological malignancies retrospective data were documented, comprising demographics, diagnosis, treatment, response, and outcome. Sites provided susceptibility results or respective isolates for analysis in a central laboratory. Results Sites in 16 countries worldwide enrolled 187 cases diagnosed with IA between 2010 and 2019; 31 (16.6%) were resistant to at least one of the clinical azoles. Fungal isolates were available from 42 cases. A mixed fungal infection was reported for 32 patients (17.1%), most were related to non-fumigatus Aspergillus and non-Aspergillus molds (n=22, 69%). Most patients were male (66.8%) and overall the majority of patients were in the age groups between 50 and 89 years (71%). Amphotericin B was used for treatment in 24 (77%) patients with azole-resistant IA, compared to 76 (49%) in the azole-susceptible group (lipid-based formulation in 98%); only five (16%) patients with azole-resistant IA were treated with an azole alone vs. 57 (36%) of those with azole-susceptible IA. Overall, all-cause mortality rate was higher for patients with azole-resistant compared to azole-susceptible IA (74.2% vs. 53.8%, log rank P=0.004), the 8 patients with an azole-resistant IA treated in the intensive care unit died within 1 month (Figure 1). Details on underlying disease and survival are given in Table 1. Table 1. Underlying hematological malignancy and clinical outcome of patients with azole-resistant and azole-susceptible invasive aspergillosis Figure 1. Intensive care unit 1-year survival probability for patients with azole-resistant and azole-susceptible invasive aspergillosis Conclusion Azole-resistance in IA is associated with worse outcome, especially in critically ill patients. Susceptibility testing should be considered in patients with a suspected azole-resistant IA to support treatment decisions. Disclosures Danila Seidel, PhD, Basilea (Other Financial or Material Support, travel grant) Oliver Cornely, Prof., Actelion (Grant/Research Support)Actelion (Other Financial or Material Support, Personal fees)Al Jazeera Pharmaceuticals (Consultant)Allecra Therapeutics (Other Financial or Material Support, Personal fees)Amplyx (Other Financial or Material Support, Personal fees)Amplyx (Grant/Research Support)Astellas (Grant/Research Support)Astellas (Other Financial or Material Support, Personal fees)Basilea (Other Financial or Material Support, Personal fees)Basilea (Grant/Research Support)Biosys UK Limited (Other Financial or Material Support, Personal fees)Cidara (Other Financial or Material Support, Personal fees)Cidara (Grant/Research Support)Da Volterra (Grant/Research Support)Da Volterra (Other Financial or Material Support, Personal fees)Entasis (Other Financial or Material Support, Personal fees)F2G (Other Financial or Material Support)F2G (Grant/Research Support)Gilead (Grant/Research Support)Gilead (Other Financial or Material Support, Personal fees)Grupo Biotoscana (Other Financial or Material Support, Personal fees)Janssen Pharmaceuticals (Grant/Research Support)Matinas (Other Financial or Material Support, Personal fees)Medicines Company (Grant/Research Support)MedPace (Grant/Research Support)MedPace (Other Financial or Material Support, Personal fees)Melinta Therapeutics (Grant/Research Support)Menarini Ricerche (Other Financial or Material Support, Personal fees)Merck/MSD (Other Financial or Material Support, Personal fees)Merck/MSD (Grant/Research Support)Mylan Pharmaceuticals (Consultant)Nabriva Therapeutics (Other Financial or Material Support, Personal fees)Octapharma (Other Financial or Material Support, Personal fees)Paratek Pharmaceuticals (Other Financial or Material Support, Personal fees)Pfizer (Other Financial or Material Support, Personal fees)Pfizer (Grant/Research Support)PSI (Other Financial or Material Support, Personal fees)Rempex (Other Financial or Material Support, Personal fees)Roche Diagnostics (Other Financial or Material Support, Personal fees)Scynexis (Other Financial or Material Support, Personal fees)Scynexis (Grant/Research Support)Seres Therapeutics (Other Financial or Material Support, Personal fees)Tetraphase (Other Financial or Material Support, Personal fees) Philipp Koehler, MD, Akademie für Infektionsmedizin e.V., (Other Financial or Material Support, Personal fees)Astellas Pharma GmbH (Other Financial or Material Support, Personal fees)Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany (Other Financial or Material Support, Other)Gilead Sciences GmbH (Other Financial or Material Support, Personal fees)GPR Academy Ruesselsheim (Speaker’s Bureau)Miltenyi Biotec GmbH (Other Financial or Material Support, Non-financial support)MSD Sharp & Dohme GmbH (Other Financial or Material Support, Personal fees)Noxxon N.V. (Speaker’s Bureau)University Hospital, LMU Munich (Other Financial or Material Support, Personal fees) Katrien Lagrou, n/a, FUJIFILM WAKO (Speaker’s Bureau)Gilead (Consultant, Speaker’s Bureau)MSD (Consultant, Speaker’s Bureau, Other Financial or Material Support, travel grant)Pfizer (Speaker’s Bureau, travel grant)SMB Laboratoires Brussels (Consultant) Zdenek Racil, n/a, Astellas (Grant/Research Support, Speaker’s Bureau, travel grant) Blandine Rammaert, n/a, Gilead (Speaker’s Bureau, Other Financial or Material Support, travel grant)Merck/MSD (Speaker’s Bureau)Pfizer (Other Financial or Material Support, travel grant) Nikolay Klimko, n/a, Astellas (Speaker’s Bureau)Gilead (Speaker’s Bureau)Merck/MSD (Speaker’s Bureau)Pfizer (Speaker’s Bureau) Sung-Yeon Cho, MD, Gilead (Grant/Research Support, Speaker’s Bureau)Merck Sharp & Dohme (Grant/Research Support, Speaker’s Bureau)Pfizer (Grant/Research Support, Speaker’s Bureau)

Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study

2018 ◽  
Vol 6 (10) ◽  
pp. 782-792 ◽  
Author(s):  
Alexander F A D Schauwvlieghe ◽  
Bart J A Rijnders ◽  
Nele Philips ◽  
Rosanne Verwijs ◽  
Lore Vanderbeke ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Invasive Aspergillosis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Influenza A ◽  
Severe Influenza

Welcome to our intensive care unit, make yourself at home!*

2009 ◽  
Vol 37 (7) ◽  
pp. 2313-2314 ◽  
Author(s):  
Jean Carlet ◽  
Maïté Garrouste-Orgeas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
At Home

scholarly journals Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience

2020 ◽  
Vol 6 (3) ◽  
pp. 105 ◽  
Author(s):  
Jean-Pierre Gangneux ◽  
Florian Reizine ◽  
Hélène Guegan ◽  
Kieran Pinceaux ◽  
Pierre Le Balch ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Invasive Aspergillosis ◽  
Molecular Detection ◽  
Good Time ◽  
Proof Of Concept ◽  
Icu Patients ◽  
Blood Samples ◽  
Fungal Burden ◽  
Higher Sensitivity

(1) Background: The diagnosis of invasive aspergillosis (IA) in an intensive care unit (ICU) remains a challenge and the COVID-19 epidemic makes it even harder. Here, we evaluated Aspergillus PCR input to help classifying IA in SARS-CoV-2-infected patients. (2) Methods: 45 COVID-19 patients were prospectively monitored twice weekly for Aspergillus markers and anti-Aspergillus serology. We evaluated the concordance between (I) Aspergillus PCR and culture in respiratory samples, and (II) blood PCR and serum galactomannan. Patients were classified as putative/proven/colonized using AspICU algorithm and two other methods. (3) Results: The concordance of techniques applied on respiratory and blood samples was moderate (kappa = 0.58 and kappa = 0.63, respectively), with a higher sensitivity of PCR. According to AspICU, 9/45 patients were classified as putative IA. When incorporating PCR results, 15 were putative IA because they met all criteria, probably with a lack of specificity in the context of COVID-19. Using a modified AspICU algorithm, eight patients were classified as colonized and seven as putative IA. (4) Conclusion: An appreciation of the fungal burden using PCR and Aspergillus serology was added to propose a modified AspICU algorithm. This proof of concept seemed relevant, as it was in agreement with the outcome of patients, but will need validation in larger cohorts.

scholarly journals ADAPTATION OF LONG-LIVED ELDERS AT HOME AFTER HOSPITALIZATION IN THE INTENSIVE CARE UNIT AND HOSPITAL DISCHARGE

2019 ◽  
Vol 28 ◽  
Author(s):  
Jessica Lane Pereira Santos ◽  
Larissa Chaves Pedreira ◽  
Juliana Bezerra do Amaral ◽  
Valdenir Almeida da Silva ◽  
Álvaro Pereira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Discharge ◽  
Critical Role ◽  
The Elderly ◽  
Support Network ◽  
Adaptation Theory ◽  
Discharge Data ◽  
Lack Of Information ◽  
At Home

ABSTRACT Objective: to identify stimuli that interfere with the adaptation of long-lived elders at home after hospitalization in the intensive care unit and hospital discharge. Method: a descriptive study with a qualitative approach, conducted with elderly individuals who were hospitalized in the intensive care unit and were already at home after hospital discharge. Data collection took place through open interviews and was performed at the intensive care unit of the hospital and at the home of the elderly. Home visits took place between December 2017 and February 2018, and were conducted in seven cities. Bardin's content analysis was used, and the discussion was based on Callista Roy's Adaptation Theory. Ethical and legal cares were strictly respected. Results: eleven long-lived elders, aged between 80 and 94 years old, took part in the study. Two categories emerged from the participants' testimonies: Stimuli that contribute to adaptive behavioral responses in the long-lived elders and Stimuli that negatively affect the adaptation of the long-lived elders. Conclusion: the main stimuli that contributed to the adaptive behavior of the long-lived elders were the return to their homes, family support and the social support network. In contrast, the stimuli that negatively affected adaptation were fear, lack of information and difficulties in continuing the care. The critical role of the health professionals in the intensive care unit and the hospital unit in preparing longevity the long-lived elders their families for hospital discharge and home return is highlighted.

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