Mixed mold pulmonary infections in haematological cancer patients in a tertiary care cancer centre

Mycoses. 2018 Nov;61(11):861-867. doi: 10.1111/myc.12830. Epub 2018 Aug 1.

Abstract

There is a paucity of data regarding mixed mold pulmonary infections (MMPIs) in patients with haematological malignancies with or without haematopoietic stem cell transplantation (HSCT). We retrospectively studied 27 such patients (2005-2015) and compared them to patients with invasive pulmonary aspergillosis (IPA) caused by Aspergillus fumigatus. Factors associated with the diagnosis of MMPIs were significant corticosteroid use [20 (74%) vs 6 (22%), P < 0.001], sputum as the source specimen [13 (48%) vs 3 (11%), P = 0.003], younger age (median age: 58 vs 66 years, P = 0.006), and male sex [22 (81%) vs 13 (48%), P = 0.01]. Haematological cancers other than acute myeloid leukaemia (AML)/myelodysplastic syndromes (MDS) were less common in MMPIs than in IPA patients [AML/MDS: 6 (22%) vs 14 (52%), P = 0.04]. Only significant corticosteroid use [95% CI (2.7-42.7), P < 0.001], and sputum as the source specimen [95% (1.6-41.6), P = 0.012] were statistically significant as independently associated with increased risk of MMPIs diagnosis in multivariate analysis. Total mortality rate at day 42 postdiagnosis was comparable in both groups.

Keywords: corticosteroids; haematological cancer; mixed molds; sputum.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aspergillus fumigatus / drug effects
  • Aspergillus fumigatus / genetics
  • Aspergillus fumigatus / isolation & purification
  • Aspergillus fumigatus / physiology
  • Female
  • Hematologic Neoplasms / drug therapy
  • Hematologic Neoplasms / microbiology
  • Hematologic Neoplasms / surgery*
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Invasive Pulmonary Aspergillosis / diagnosis
  • Invasive Pulmonary Aspergillosis / drug therapy
  • Invasive Pulmonary Aspergillosis / etiology
  • Invasive Pulmonary Aspergillosis / microbiology*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Postoperative Complications / microbiology*
  • Retrospective Studies
  • Tertiary Healthcare / statistics & numerical data
  • Young Adult