The epidemiology of fusariosis in patients with haematological diseases

Abstract

Fusariosis has been considered an emerging infection in patients with haematological malignancies. In a multicentre retrospective study on filamentous fungi infections in patients with haematological diseases over a period of 10 years in Italy, fusariosis was documented in six patients from two of the 14 centres with a 0.06% incidence in acute leukaemia. A literature search yielded 177 cases of Fusarium infections in haematological diseases and acute leukaemia accounted for 71% of the underlying conditions. An increase from 0.5 to 3.8 cases per year was observed at the M.D. Anderson Cancer Center of Houston in the periods 1975-85 and 1986-95 respectively. Conversely, only 5.1 and 6.3 cases per year have been reported in the periods 1981-90 and 1991-96, respectively, from the other centres in the world. Half of the cases have been observed in the USA. In Europe, most of the cases have been observed in France and Italy. Invasive fusariosis is a rare complication in haematological diseases, as its overall frequency does not seem to be significantly increased within the last 20 years. However, its epidemiological distribution is not homogeneous and the possibility of local clusters of infections by this deadly pathogen should be carefully considered.

Clinical and Epidemiological Aspects of Infections Caused byFusariumSpecies: a Collaborative Study from Israel

“…However, there are two agriculturally significant F. oxysporum forms that are considered winter pathogens (9,17). Moreover, in Israel, fusarial infections are unrelated to rain and wind, in contrast to previous reports from other countries (3,10,30), since Israeli summers are rainless and hot (around 30°C). It is conceivable that the humidity, which is high in the coastal plain in the summer (55 to 70%) and low in the mountains (40 to 55%) (4), may partly explain the differences between these regions, as presented by more cases per 1,000 admissions in Sheba Medical Center, which is located in the coastal plain, than in the Hadassah University Hospital, located in the mountains of Jerusalem.…”

“…The infection is most prevalent in autumn in France (16) and in summer in Texas and Italy (3,10,30). In Israel, the highest incidence of Fusarium species isolation was in the summer, particularly among patients from rural areas, and was associated with ocular and respiratory tract infections (6,30).…”

“…The frequency of isolation of Fusarium species varies between different countries (3,10,16). Such variation was also observed between two different geographical regions within Israel.…”

“…In recent years, there have been an increasing number of reports of human infection due to Fusarium species, mostly involving immunocompromised hosts (3,10,16,19). Some consider it the second most common mold pathogen in these patients (8), causing localized infection, deep-seated skin infections, and disseminated disease.…”

Voriconazole and its clinical potential in the prophylaxis of systemic fungal infection in patients with hematologic malignancies: a perspective review

“…Pulmonary IA is the most common cause of pneumoniarelated mortality in allogeneic SCT recipients and patients with leukemia [Kontoyiannis et al 2010]. A prospective US study of 234 SCT recipients reported that IA was the most frequent IFI (59.2%), followed by IC (24.8%) [Girmenia et al 2000;Pagano et al 2006].…”