Revision of antifungal strategies definitions for invasive fungal infections (proven/probable/possible) in 461 patients with haematological malignancies ( REDEFI ‐ SEIFEM )
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Invasive fungal infections (IFI) are a relevant cause of morbidity and mortality among patients with haematological neoplasms (HMs). Since 2002, a classification of IFI based on host factors, clinical and radiological features and mycological tests was published for research purpose. OBJECTIVES: These criteria are widely used in clinical practice to identify patients at risk for IFI. The aim of the study was to evaluate the clinical applicability of EORTC/MSG 2008 criteria for the diagnosis of IFI in daily practice. PATIENTS/METHODS: This multicentre, non-interventional, observational, prospective study gathered all consecutive inpatients with HMs in which an intravenous antifungal treatment was started. Exclusion criteria were a previous or concomitant transplant procedure, outpatient status and oral antifungal therapy. EORTC/MSG 2008 criteria were used to classify patients at the beginning of antifungal therapy and at 30 days. An independent board reviewed the classification of IFI given by local clinicians at T0 and T30. RESULTS: The highest percentage of agreement was found for possible IFI (96%), while a lower agreement was reported for proven IFI (74%), and the highest variability was observed for probable IFI (56%). At T30, the board re-evaluation confirmed a strict agreement for possible IFI only (98%). Among 306 patients classified as possible, 156 (51%) patients showed non-typical radiological findings and 45 (15%) patients presented host factors only. CONCLUSIONS: In real life, the EORTC/MSG criteria can be applicable only for possible IFI. As non-typical radiological findings are reported in possible IFI, introducing a new IFI category should be considered.
Source: Mycoses
DOI: 10.1111/myc.13781
Authors: Marianna Criscuolo, Matteo Bonanni, Alfonso Piciocchi, Francesca Farina, Luisa Verga, Francesco Marchesi, Claudia Basilico, Maria Ilaria Del Principe, Maria Chiara Tisi, Chiara Cattaneo, Marco Picardi, Valentina Bonuomo, Nicola Fracchiolla, Anna Candoni, Katia Perruccio, Marta Stanzani, Anna Rita Larici, Maurizio Sanguinetti, Alessandro Busca, Livio Pagano, SEIFEM (Sorveglianza Epidemiologica Infezioni nelle Emopatie Maligne) group
Institutions: Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Università Cattolica del Sacro Cuore, Fondazione Gimema Onlus, IRCCS Ospedale San Raffaele, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, Instituto Nazionale Tumori Regina Elena, Ospedale di Circolo e Fondazione Macchi, Aziende Socio Sanitarie Territoriale dei Sette Laghi, University of Rome Tor Vergata, Ospedale San Bortolo, Azienda ULSS 8 Berica, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Federico II University Hospital, University of Naples Federico II, University of Verona, University of Turin, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Ca' Foncello Hospital, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4401653656