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Invasive mold infections occurred with absence of prophylaxis covering

Issue: October 2011

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Acquisition of invasive mold infections remains frequent for acute leukemia and bone marrow transplant patients with the absence of prophylaxis covering molds outside and inside the hospital, according to research presented here.

Researchers identified neutropenic patients at risk for invasive mold infections hospitalized in 2009 and 2010 and found an increased incidence of invasive mold infections in acute leukemia and bone marrow transplant patients. Microbiology data and CT scans were reviewed, and episodes of invasive mold infections occurring during neutropenia were classified into possible, probable and proven cases, according to the study.

Researchers found that five of 34 bone marrow transplant patients acquired invasive mold infections outside the hospital and one acquiring invasive mold infections during hospital stay (incidence=3.4%; 95% CI, 0.09-17.8) in 2009 vs. three of 31 bone marrow transplant patients acquiring invasive mold infections outside and eight acquiring invasive mold infections while hospitalized (incidence=30.8; 95% CI, 14.3-51.8) in 2010. Of 26 patients treated for acute leukemia, four acquired invasive mold infections outside and four during hospital stay (incidence=18.2%; 95% CI, 5.2-40.3) in 2009 vs. five of 22 acute leukemia patients acquiring invasive mold infections outside and seven during hospital stay (incidence=41.2%; 95% CI, 18.4-67.1) in 2010.

Because of the results, researchers implemented additional preventive and protective measures, as well as changed the standard prophylaxis from fluconazole 200 mg per day to voriconazole 400 mg per day, according to the study.

For more information:

• Van Delden C. #1121. Presented at: 2011 Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 17-20; Chicago.

Disclosure: Dr. Van Delden reports serving as a scientific adviser and receiving consulting fees from Basilea, Merck Sharp & Dohme, Gilead and Pfizer.

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