From Duke U: Invasive Aspergillosis

http://www.ncbi.nlm.nih.gov/pubmed/22898389

J Infect. 2012 Aug 13. [Epub ahead of print]

Clinical Epidemiology of 960 Patients with Invasive Aspergillosis from the PATH Alliance registry.

Steinbach WJ, Marr KA, Anaissie EJ, Azie N, Quan SP, Meier-Kriesche U, Apewokin S, Horn DL.

Source

Division of Pediatric Infectious Diseases, Departments of Pediatrics and Molecular Genetics & Microbiology, 427 Jones Building, Duke University Medical Center, Durham, NC 27710, USA.

Abstract

OBJECTIVES:

The study investigated the epidemiology and outcome of invasive aspergillosis (IA), an important cause of morbidity and mortality in immunocompromised patients.

METHODS:

Cases of proven/probable IA from the Prospective Antifungal Therapy Alliance (PATH Alliance(®)) registry-a prospective surveillance network comprising 25 centers in the United States and Canada that collected data on invasive fungal infections from 2004-2008-were analyzed with respect to clinical outcome.

RESULTS:

960 patients with IA were enrolled, the most frequent underlying disease being hematologic malignancy (n=464 [48.3%]). 280 patients (29.2%) received solid organ transplant; 268 patients (27.9%) underwent hematopoietic stem cell transplantation. Identified isolates included Aspergillus fumigatus (72.6%), A. flavus (9.9%), A. niger (8.7%) and A. terreus (4.3%). The lung was most frequently affected. Following diagnosis, 47% patients received monotherapy-voriconazole (70%), an amphotericin B formulation (13.8%), or an echinocandin (10.5%)-while 279 patients (29%) received combination therapy. Twelve-week overall survival was 64.4%.

CONCLUSIONS:

In this series of patients with IA, the lung was the predominant focus of infection, A. fumigatus was the major species isolated, and overall survival appeared slightly improved compared with previous reports.