The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole-resistance:A nationwide survey and rationale for the DB‐MSG 002 study protocol

Patients with haematological malignancies are at risk for invasive fungal diseases (IFD). A survey was conducted in all Dutch academic haematology centres on their current diagnostic, prophylactic and therapeutic approach towards IFD in the context of azole-resistance. In all 8 centres, a haematologist and microbiologist filled in the questionnaire that focused on different subgroups of haematology patients. Fungal prophylaxis during neutropaenia was directed against Candida and consisted of fluconazole and/or amphotericin B suspension. Mould-active prophylaxis was given to acute myeloid leuka... Mehr ...

Verfasser: Schauwvlieghe, Alexander F. A. D.
de Jonge, Nick
van Dijk, Karin
Verweij, Paul E.
Bruggemann, Roger J.
Biemond, Bart J.
Bart, Aldert
von dem Borne, Peter A.
Verbon, Annelies
van der Beek, Martha T.
Demandt, Astrid M. P.
Oudhuis, Guy J.
Cornelissen, Jan J.
van der Velden, Walter J. F. M.
Span, Lambert F. R.
Kampinga, Greetje A.
Bruns, Anke H.
Vonk, Alieke G.
Haas, Pieter-Jan A.
Doorduijn, Jeanette K.
Rijnders, Bart J. A.
Dokumenttyp: Artikel
Erscheinungsdatum: 2018
Reihe/Periodikum: Schauwvlieghe , A F A D , de Jonge , N , van Dijk , K , Verweij , P E , Bruggemann , R J , Biemond , B J , Bart , A , von dem Borne , P A , Verbon , A , van der Beek , M T , Demandt , A M P , Oudhuis , G J , Cornelissen , J J , van der Velden , W J F M , Span , L F R , Kampinga , G A , Bruns , A H , Vonk , A G , Haas , P-J A , Doorduijn , J K & Rijnders , B J A 2018 , ' The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole-resistance : A nationwide survey and rationale for the DB‐MSG 002 study protocol ' , Mycoses , vol. 61 , no. 9 , pp. 656-664 . https://doi.org/10.1111/myc.12788
Schlagwörter: azole-resistance / IFD / invasive aspergillosis / management / BRONCHOALVEOLAR LAVAGE FLUID / LIPOSOMAL AMPHOTERICIN-B / PLACEBO-CONTROLLED TRIAL / ACUTE MYELOID-LEUKEMIA / FUNGAL-INFECTIONS / FLUCONAZOLE PROPHYLAXIS / MOLD INFECTIONS / FUMIGATUS / POSACONAZOLE / DISEASE
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29021537
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://cris.maastrichtuniversity.nl/en/publications/dc9ce80c-b183-4445-8245-3e06431408d9

Patients with haematological malignancies are at risk for invasive fungal diseases (IFD). A survey was conducted in all Dutch academic haematology centres on their current diagnostic, prophylactic and therapeutic approach towards IFD in the context of azole-resistance. In all 8 centres, a haematologist and microbiologist filled in the questionnaire that focused on different subgroups of haematology patients. Fungal prophylaxis during neutropaenia was directed against Candida and consisted of fluconazole and/or amphotericin B suspension. Mould-active prophylaxis was given to acute myeloid leukaemia patients during chemotherapy in 2 of 8 centres. All centres used azole prophylaxis in a subset of patients with graft-versus-host disease. A uniform approach towards the diagnosis and treatment of IFD and in particular azole-resistant Aspergillus fumigatus was lacking. In 2017, all centres agreed to implement a uniform diagnostic and treatment algorithm regarding invasive aspergillosis with a central role for comprehensive diagnostics and PCR-based detection of azole-resistance. This study (DB-MSG 002) will re-evaluate this algorithm when 280 patients have been treated. A heterogeneous approach towards antifungal prophylaxis, diagnosis and treatment was apparent in the Netherlands. Facing triazole-resistance, consensus was reached on the implementation of a uniform diagnostic approach in all 8 centres.