Abstract
The frequency of breakthrough invasive fungal diseases (IFDs) during echinocandin therapy is unclear. We retrospectively analyzed 534 hematologic patients treated with echinocandin (caspofungin, N = 55; micafungin, N = 306; anidulafungin, N = 173). Four proven IFDs were found, caused by Candida parapsilosis (N = 2), C. parapsilosis and Candida glabrata (N = 1), and Fusarium species (N = 1). Four cases of possible IFDs were observed, all showing pulmonary infection. One case showed features suggestive of hepatosplenic candidiasis. Six of these eight cases had previously received the purine analog clofarabine. Breakthrough IFD during echinocandin treatment occurred infrequently (1.5 %), caused predominantly by Candida species. Clofarabine usage was an important risk factor.
MeSH terms
-
Adenine Nucleotides / adverse effects
-
Adenine Nucleotides / therapeutic use
-
Adult
-
Anidulafungin
-
Antibiotic Prophylaxis*
-
Antifungal Agents / therapeutic use
-
Antimetabolites, Antineoplastic / adverse effects
-
Antimetabolites, Antineoplastic / therapeutic use
-
Arabinonucleosides / adverse effects
-
Arabinonucleosides / therapeutic use
-
Candida / drug effects*
-
Candida / immunology
-
Candida / isolation & purification
-
Candidiasis, Invasive / epidemiology
-
Candidiasis, Invasive / immunology
-
Candidiasis, Invasive / prevention & control*
-
Candidiasis, Invasive / virology
-
Caspofungin
-
China / epidemiology
-
Clofarabine
-
Cohort Studies
-
Cross Infection / epidemiology
-
Cross Infection / immunology
-
Cross Infection / prevention & control
-
Cross Infection / virology
-
Echinocandins / therapeutic use*
-
Fusariosis / epidemiology
-
Fusariosis / immunology
-
Fusariosis / prevention & control*
-
Fusariosis / virology
-
Fusarium / drug effects*
-
Fusarium / immunology
-
Fusarium / isolation & purification
-
Hematologic Diseases / complications
-
Hematologic Diseases / immunology*
-
Hematologic Diseases / therapy
-
Hematologic Diseases / virology
-
Hematopoietic Stem Cell Transplantation / adverse effects
-
Humans
-
Immunocompromised Host
-
Lipopeptides / therapeutic use*
-
Lung Diseases, Fungal / epidemiology
-
Lung Diseases, Fungal / immunology
-
Lung Diseases, Fungal / prevention & control
-
Lung Diseases, Fungal / virology
-
Micafungin
-
Retrospective Studies
-
Risk Factors
Substances
-
Adenine Nucleotides
-
Antifungal Agents
-
Antimetabolites, Antineoplastic
-
Arabinonucleosides
-
Echinocandins
-
Lipopeptides
-
Clofarabine
-
Anidulafungin
-
Caspofungin
-
Micafungin