Invasive fungal infection among hematopoietic stem cell transplantation patients with mechanical ventilation in the intensive care unit

BMC Infectious Diseases

Cheng-Ta Yang¹  Ying-Huang Tsai¹  Chung-Chi Huang¹  Li-Fu Li¹  Chih-Hao Chang¹  Jui-Ying Fu¹  Meng-Jer Hsieh¹  Han-Chung Hu¹  Po-Nan Wang²  Kuo-Chin Kao¹  Chen-Yiu Hung¹ 

[1] Department of Respiratory Care, Chang-Gung University College of Medicine, Taipei, Taiwan;Division of Hematology-Oncology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan

关键词: Risk factor;    Outcome assessment;    Intensive care unit (ICU);    Hematopoietic stem cell transplantation (HSCT);    Invasive fungal infection (IFI);   

Others  :  1175446
DOI  :  10.1186/1471-2334-12-44

 received in 2011-06-23, accepted in 2012-02-18,  发布年份 2012

【 摘 要 】

Background

Invasive fungal infection (IFI) is associated with high morbidity and high mortality in hematopoietic stem cell transplantation (HSCT) patientsThe purpose of this study was to assess the characteristics and outcomes of HSCT patients with IFIs who are undergoing MV at a single institution in Taiwan.

Methods

We performed an observational retrospective analysis of IFIs in HSCT patients undergoing mechanical ventilation (MV) in an intensive care unit (ICU) from the year 2000 to 2009. The characteristics of these HSCT patients and risk factors related to IFIs were evaluated. The status of discharge, length of ICU stay, date of death and cause of death were also recorded.

Results

There were 326 HSCT patients at the Linkou Chang-Gung Memorial Hospital (Taipei, Taiwan) during the study period. Sixty of these patients (18%) were transferred to the ICU and placed on mechanical ventilators. A total of 20 of these 60 patients (33%) had IFIs. Multivariate analysis indicated that independent risk factors for IFI were admission to an ICU more than 40 days after HSCT, graft versus host disease (GVHD), and high dose corticosteroid (p < 0.01 for all). The overall ICU mortality rate was 88% (53 of 60 patients), and was not significantly different for patients with IFIs (85%) and those without IFIs (90%, p = 0.676).

Conclusion

There was a high incidence of IFIs in HSCT patients requiring MV in the ICU in our study cohort. The independent risk factors for IFI are ICU admission more than 40 days after HSCT, GVHD, and use of high-dose corticosteroid.

【 授权许可】

   
2012 Hung et al; BioMed Central Ltd.

【 图 表 】

Figure 1.

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