Deferoxamine Therapy and Mucormycosis in Dialysis Patients: Report of an International Registry

Boelaert, Johan R.; Fenves, Andrew Z.; Coburn, Jack W.

doi:10.1016/s0272-6386(12)80606-8

Cited by 196 publications

(101 citation statements)

References 32 publications

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“…Since then, a substantial number of such cases have been recognized in dialysis patients treated with deferoxamine B (DFO)' for either aluminum or iron overload. An international registry of mucormycosis in dialysis patients was established in order to gain more clinical information on the possible association with this drug therapy (2). Up to March 1991, 59 dialysis patients who had developed mucormycosis were reported to this registry.…”

mentioning

confidence: 99%

Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies.

Boelaert¹,

Locht²,

Cutsem³

et al. 1993

J. Clin. Invest.

315

263

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mentioning

confidence: 99%

Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies.

Boelaert¹,

Locht²,

Cutsem³

et al. 1993

J. Clin. Invest.

315

263

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“…The median LOS was 7 days (5-12), which was not significantly different between the groups that received (7 days [4][5][6][7][8][9][10][11]) and did not receive intravenous iron (7 days [5][6][7][8][9][10][11][12]; P=0.29). There were 3220 patients (14.1% of the cohort) who were readmitted for infection or died from any cause within 30 days of discharge.…”

Section: Associations Of Intravenous Iron With Adverse Outcomesmentioning

confidence: 99%

“…Although an association between iron and viral and fungal infections has been described (5,6), the literature in hemodialysis patients has pertained largely to bacterial infections, with a particular emphasis on systemic infections (e.g., bacteremia) (7). Results from studies evaluating the association between intravenous iron and bacterial infection in hemodialysis patients have been conflicting, and prior studies have had limitations such as the use of serum ferritin as a predictor, lack of control for confounding and residual confounding, small sample size, short follow-up time, and publication bias (7).…”

Section: Introductionmentioning

confidence: 99%

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Receipt of Intravenous Iron and Clinical Outcomes among Hemodialysis Patients Hospitalized for Infection

Ishida

Marafino

McCulloch

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Anemia guidelines for CKD recommend withholding intravenous iron in the setting of active infection, although no data specifically support this recommendation. This study aimed to examine the association between intravenous iron and clinical outcomes among hemodialysis patients hospitalized for infection.Design, setting, participants, & measurements This was a retrospective observational cohort study using data from the US Renal Data System of 22,820 adult Medicare beneficiaries on in-center hemodialysis who had received intravenous iron in the 14 days preceding their first hospitalization for bacterial infection in 2010. In multivariable analyses, the association between receipt of intravenous iron at any point from the day of hospital admission to discharge and all-cause 30-day mortality, mortality in 2010, length of hospital stay, and readmission for infection or death within 30 days of discharge was evaluated.Results There were 2463 patients (10.8%) who received intravenous iron at any point from the day of admission to discharge. Receipt of intravenous iron was not associated with age, dialysis vintage, or comorbidities. There were 2618 deaths within 30 days of admission and 6921 deaths in 2010 (median follow-up 173 days; 25th and 75th percentiles, 78-271 days). The median length of stay was 7 days (25th and 75th percentiles, 5-12 days). Receipt of intravenous iron was not associated with higher 30-day mortality (odds ratio, 0.86; 95% confidence interval [95% CI], 0.74 to 1.00), higher mortality in 2010 (hazard ratio, 0.92; 95% CI, 0.85 to 1.00), longer mean length of stay (10.1 days [95% CI, 9.7 to 10.5] versus 10.5 days [95% CI, 10.3 to 10.7]; P=0.05), or readmission for infection or death within 30 days of discharge (odds ratio, 1.08; 95% CI, 0.96 to 1.22) compared with no receipt of intravenous iron.Conclusions This analysis does not support withholding intravenous iron upon admission for bacterial infection in hemodialysis patients, although clinical trials are required to make definitive recommendations.

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“…Other conditions associated with Zygomycoses are burns, leukemia, lymphoma [9][10], and the use of certain drugs like deferrioxamine [11]. Zygomycetes are divided into two groups-Entomophthorales and Mucorales.…”

Section: Introductionmentioning

confidence: 99%

Zygomycoses - urgency in diagnosis

Abraham

Oberoi

Dewan

et al. 2015

IJBAS

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Introduction: Zygomycoses is an angioinvasive infection most commonly seen in immunocompromised and diabetic patients. We undertook this study to determine the prevalence of Zygomycoses, in patients with a suspected Invasive Zygomycoses Infection in a tertiary centre and to identify the most common species isolated from culture. Materials and Methods: A retrospective analysis was done from January 1, 2012 to December 8, 2014; the clinical data of the suspected patients and the positive cultures were collected. Results and Discussion: A total of 50 samples of 27 patients with suspected Zygomycoses were sent during the 3 year period. In 25 of these patients, the samples sent were tissue biopsies from nasal cavity and 2 wound swabs from burns. Of these, 18 tissue biopsies of 13 patients and two wound swabs were detected positive for Zygomycetes. (2-Absidia corymbifera; 1-Rhizopus, 15-Mucor). Of the remaining 12 patients whose cultures were negative, 1-bacterial 1-bacterial sinusitis, 5-Invasive aspergillosis; 6-treated as Invasive fungal infections due to Zygomycetes as the imaging diagnostics and histopathological features favored that diagnosis. The majority of the patients (80%) were diabetic, and the two from the burn unit were under long-term treatment for chronic wound infections. Multiple diagnostic modalities must be used in view of the aggressive nature of the disease, but microbiological diagnosis remains the Gold Standard.

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Deferoxamine Therapy and Mucormycosis in Dialysis Patients: Report of an International Registry

Cited by 196 publications

References 32 publications

Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies.

Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies.

Receipt of Intravenous Iron and Clinical Outcomes among Hemodialysis Patients Hospitalized for Infection

Zygomycoses - urgency in diagnosis

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