Clinical features and analysis of risk factors for invasive candidal infection after marrow transplantation

James M. Goodrich, Elizabeth C. Reed, Motomi Mori, Lloyd D. Fisher, Shawn Skerrett, Paula S. Dandliker, Barbara Klis, George W. Counts, Joel D. Meyers

Research output: Contribution to journalArticlepeer-review

226 Scopus citations

Abstract

Of 1506 marrow transplant patients from 1980 through 1986 reviewed for risk factors for invasive candidal infection defined by positive blood cultures, biopsy, or histologic evidence of tissue invasion, 171 (11.4%) had invasive infection, with a significantly higher incidence in the more recent years of review; 40% (69 patients) had evidence of tissue-invasive disease without fungemia. Of 102 patients with fungemia, 45% had candidemia alone with a mortality of 39%. Mortality in patients with tissue involvement was 90% with or without fungemia. Factors that increased infection were age, acute graft-versus-host disease, and donor mismatch. Factors that decreased infection included conditioning with 12 Gy of fractionated irradiation and cyclophosphamide, transplantation for aplastic anemia, and more rapid engraftment. Among fungemic patients, the number of days of fungemia was a risk factor for tissue invasion while more rapid engraftment was protective.

Original languageEnglish (US)
Pages (from-to)731-740
Number of pages10
JournalJournal of Infectious Diseases
Volume164
Issue number4
DOIs
StatePublished - Oct 1991
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine

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