Fungemia in Hospitalized Adult Patients with Hematological Malignancies: Epidemiology and Risk Factors.

Fungemia in hematologic malignancies (HM) has high mortality. This is a retrospective cohort of adult patients with HM and fungemia between 2012 and 2019 in institutions of Bogotá, Colombia. The epidemiological, clinical, and microbiological characteristics are described, and risk factors related to mortality are analyzed. One hundred five patients with a mean age of 48 years (SD 19.0) were identified, 45% with acute leukemia and 37% with lymphomas. In 42%, the HM was relapsed/refractory, 82% ECOG > 3, and 35% received antifungal prophylaxis; 57% were in neutropenia, with an average duration of 21.8 days. In 86 (82%) patients, Candida spp. was identified, and other yeasts in 18%. The most frequent of the isolates were non-albicans Candida (61%), C. tropicalis (28%), C. parapsilosis (17%), and C. krusei (12%). The overall 30-day mortality was 50%. The survival probability at day 30 in patients with leukemia vs. lymphoma/multiple myeloma (MM0 group was 59% (95% CI 46-76) and 41% (95% CI 29-58), p = 0.03, respectively. Patients with lymphoma or MM (HR 1.72; 95% CI 0.58-2.03) and ICU admission (HR 3.08; 95% CI 1.12-3.74) were associated with mortality. In conclusion, in patients with HM, non-albicans Candida species are the most frequent, and high mortality was identified; moreover, lymphoma or MM and ICU admission were predictors of mortality.

[Search for tuberculosis in patients with the respiratory symptoms in four hospitals of Bogotá D.C]. / Búsqueda de Tuberculosis en Pacientes Sintomáticos Respiratorios en Cuatro Hospitales de Bogotá D.C.

OBJECTIVE: To identify individuals with the respiratory symptoms who receive different medical services in third level hospitals of Bogotá D.C. for early diagnosis of Tuberculosis. MATERIALS AND METHODS: An active search for individuals with Tuberculosis respiratory symptoms through promotion and prevention activities was realized utilizing a format for obtaining social, demographic and clinical data. 566 samples of sputum from 354 individuals with respiratory symptoms were investigated in four Bogota hospitals. By means of positive smear and bacillus culture the tuberculosis patients were detected. RESULTS: The gender distribution was 39 % male and 61 % female, with an average age of 57,4 years. 48,5 % had respiratory symptoms for more than two months, 53,3 % presented BCG scar, 50 % belonged to socioeconomic level 2 and 72,8 % had an education level equal to or less than basic elementary school. The percentage detected by positive smear was of 3,67 % and by positive smear and/or culture was of 4,2 %. 11 cases of Mycobacterium tuberculosis and 2 cases of non tuberculosis mycobacterium were found. The majority of patients with tuberculosis belonged to the masculine gender, presented coughing symptoms and expectoration greater than two months and 54,5 % had BCG vaccination. CONCLUSIONS: The active search patients with the respiratory symptoms detected cases of patients with positive smear, a source of contamination among the population, which facilitates the anti-tuberculosis therapy applying the DOTS strategy. The success of tuberculosis control will depend on government policies that follow the OMS recommendations.

Búsqueda de Tuberculosis en Pacientes Sintomáticos Respiratorios en Cuatro Hospitales de Bogotá D.C. / Search for Tuberculosis in patients with the respiratory symptoms in four hospitals of Bogotá D.C.

Objetivo: Identificar individuos sintomáticos respiratorios que acuden a diferentes servicios médicos en hospitales de tercer nivel de Bogotá D.C. para el diagnóstico temprano de la Tuberculosis. Materiales y métodos: Se realizó búsqueda activa de sintomáticos respiratorios a través de actividades de promoción y prevención utilizando un formulario para obtención de datos socio demográficos y clínicos. Se investigaron 566 muestras de esputo de 354 individuos sintomáticos respiratorios en cuatro hospitales de Bogotá D.C. Se detecto por baciloscopia y cultivo pacientes con tuberculosis. Resultados La distribución por género fue de 39 por ciento masculino y 61 por ciento femenino, con un promedio de 57,4 años. El 48,5 por ciento tenían síntomas respiratorios mayor a dos meses, 53,3 por ciento presentaban cicatriz BCG, 50 por ciento pertenecía al estrato 2 y 72,8 por ciento alcanzaba un nivel educativo igual o menor a primaria básica. El porcentaje de captación por baciloscopia fue de 3,67 por ciento y de baciloscopia y/o cultivo fue del 4,2 por ciento. Se encontraron 11 casos de Mycobacterium tuberculosis y 2 casos de micobacterias no tuberculosas. La mayoría de pacientes con tuberculosis perteneció al género masculino, presentaban síntomas de tos y expectoración mayor a dos meses y el 54,5 por ciento tenían vacunación BCG Conclusiones: La búsqueda activa de sintomáticos respiratorios detecta casos de pacientes bacilíferos, fuente de contaminación entre la población, facilita el inicio de la terapia antituberculosa aplicando la estrategia DOTS. El éxito en el control de la tuberculosis depende de políticas gubernamentales que sigan las recomendaciones de la OMS.

Objective: To identify individuals with the respiratory symptoms who receive different medical services in third level hospitals of Bogotá D.C. for early diagnosis of Tuberculosis. Materials and methods: An active search for individuals with Tuberculosis respiratory symptoms through promotion and prevention activities was realized utilizing a format for obtaining social, demographic and clinical data. 566 samples of sputum from 354 individuals with respiratory symptoms were investigated in four Bogota hospitals. By means of positive smear and bacillus culture the tuberculosis patients were detected. Results The gender distribution was 39 percent male and 61 percent female, with an average age of 57,4 years. 48,5 percent had respiratory symptoms for more than two months, 53,3 percent presented BCG scar, 50 percent belonged to socioeconomic level 2 and 72,8 percent had an education level equal to or less than basic elementary school. The percentage detected by positive smear was of 3,67 percent and by positive smear and/or culture was of 4,2 percent. 11 cases of Mycobacterium tuberculosis and 2 cases of non tuberculosis mycobacterium were found. The majority of patients with tuberculosis belonged to the masculine gender, presented coughing symptoms and expectoration greater than two months and 54,5 percent had BCG vaccination. Conclusions: The active search patients with the respiratory symptoms detected cases of patients with positive smear, a source of contamination among the population, which facilitates the anti-tuberculosis therapy applying the DOTS strategy. The success of tuberculosis control will depend on government policies that follow the OMS recommendations.