Clinical Characteristics, Prognosis Factors and Metagenomic Next-Generation Sequencing Diagnosis of Mucormycosis in patients With Hematologic Diseases.
Mycopathologia
; 189(4): 71, 2024 Aug 01.
Article
en En
| MEDLINE
| ID: mdl-39088077
ABSTRACT
INTRODUCTION:
New diagnostic methods and antifungal strategies may improve prognosis of mucormycosis. We describe the diagnostic value of metagenomic nextâgeneration sequencing (mNGS) and identify the prognostic factors of mucormycosis.METHODS:
We conducted a retrospective study of hematologic patients suffered from mucormycosis and treated with monotherapy [amphotericin B (AmB) or posaconazole] or combination therapy (AmB and posaconazole). The primary outcome was 84-day all-cause mortality after diagnosis.RESULTS:
Ninety-five patients were included, with "proven" (n = 27), "probable" (n = 16) mucormycosis confirmed by traditional diagnostic methods, and "possible" (n = 52) mucormycosis with positive mNGS results. The mortality rate at 84 days was 44.2%. Possible + mNGS patients and probable patients had similar diagnosis processes, overall survival rates (44.2% vs 50.0%, p = 0.685) and overall response rates to effective drugs (44.0% vs 37.5%, p = 0.647). Furthermore, the median diagnostic time was shorter in possible + mNGS patients than proven and probable patients (14 vs 26 days, p < 0.001). Combination therapy was associated with better survival compared to monotherapy at six weeks after treatment (78.8% vs 53.1%, p = 0.0075). Multivariate analysis showed that combination therapy was the protective factor (HR = 0.338, 95% CI 0.162-0.703, p = 0.004), though diabetes (HR = 3.864, 95% CI 1.897-7.874, p < 0.001) and hypoxemia (HR = 3.536, 95% CI 1.874-6.673, p < 0.001) were risk factors for mortality.CONCLUSIONS:
Mucormycosis is a life-threatening infection. Early management of diabetes and hypoxemia may improve the prognosis. Exploring effective diagnostic and treatment methods is important, and combination antifungal therapy seems to hold potential benefits.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Anfotericina B
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Secuenciación de Nucleótidos de Alto Rendimiento
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Enfermedades Hematológicas
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Mucormicosis
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Antifúngicos
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Mycopathologia
Año:
2024
Tipo del documento:
Article
País de afiliación:
China