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Hematological malignancies increase risk of C. tropicalis fungemia

מתוך medicontext.co.il

By David Douglas

NEW YORK (Reuters Health) – Leukemia and prolonged neutropenia are among the risk factors for Candida tropicalis infection in cancer patients, according to researchers at the University of Texas.

Dr. Dimitrios P. Kontoyiannis and colleagues at M. D. Anderson Cancer Center, Houston, note that in patients with malignancy, C. tropicalis is one of the leading species other than C. albicans to cause fungemia. However, they point out, unlike the case with C. albicans, risk factors and other aspects of C. tropicalis fungemia "have been incompletely characterized."

To investigate, the researchers compared 43 cancer patients who had C. tropicalis fungemia with 148 patients who had C. albicans fungemia. Patients with mixed fungemia were excluded. The findings appeared in November 15th issue of Clinical Infectious Diseases.

Patients infected with C. tropicalis were significantly more likely to have leukemia, to have prolonged neutropenia, and to have had positive blood cultures on more than 1 day. In addition, they were more likely to have previously had neutropenia and have had a longer stay in intensive care during the course of the infection. Overall, 44% of C. tropicalis patients had leukemia, whereas 76% of C. albicans patients had an underlying solid tumor.

Summing up, Dr Kontoyiannis, told Reuters Health that "this non-albicans Candida species remains an important invasive fungal pathogen, especially in neutropenic patients having hematologic malignancies, including those receiving fluconazole." Poor prognostic factors "are having leukemia as the underlying disease, persistent neutropenia, and possibly breakthrough fungemia."

This information, he added, should help "clinicians to understand the natural history of this opportunistic mycosis in heavily immunosuppressed patients with malignancy."

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