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Title: Rhodotorula infection in haematological patient: Risk factors and outcome
Authors: Leonardo Potenza
Maria N. Chitasombat
Nikolay Klimko
Francesca Bettelli
Giulia Dragonetti
Maria Ilaria Del Principe
Marcio Nucci
Alessandro Busca
Nicola Fracchiolla
Mariarita Sciumè
Angelica Spolzino
Mario Delia
Valentina Mancini
Gian Paolo Nadali
Michela Dargenio
Olga Shadrivova
Federico Bacchelli
Franco Aversa
Maurizio Sanguinetti
Mario Luppi
Dimitrios P. Kontoyiannis
Livio Pagano
Azienda Ospedaliera - Universitaria Città della Salute e della Scienza di Torino
Ospedale Vito Fazzi
Fondazione Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica del Sacro Cuore
Università degli Studi di Verona
Università degli Studi di Roma Tor Vergata
Università degli Studi di Bari
Azienda Ospedaliero - Universitaria di Modena Policlinico
North-Western State Medical University named after I.I. Mechnikov
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Ospedale Niguarda, Milan
University of Texas MD Anderson Cancer Center
Ospedale Maggiore Policlinico Milano
Università degli Studi di Parma
Università degli Studi di Modena e Reggio Emilia
Universidade Federal do Rio de Janeiro
Keywords: Medicine
Issue Date: 1-Jan-2018
Citation: Mycoses. (2018)
Abstract: © 2018 Blackwell Verlag GmbH Background: Rhodotorula spp are uncommon yeasts able to cause infections with high mortality rates. Rhodotorula infections have been associated with the presence of central venous catheter (CVC), immunosuppression, exposure to antifungals and the presence of either solid or haematologic malignancies. However, in this latter setting, only a few cases have so far been reported. Objectives: We have conducted a survey for Rhodotorula infections in haematologic patients. Methods: Patients’ clinical and microbiological data were collected and correlated to the outcome. Results: A total of 27 cases were detected from 13 tertiary care hospitals. About 78% and 89% of patients had acute leukaemia and CVC. About 70% of patients were exposed to prophylaxis with azoles, mainly posaconazole (37%), 59% were severely neutropenic and 37% underwent allogeneic stem cell transplantation (alloSCT). The most frequent treatments were liposomal amphotericin B (L-AmB) and CVC removal in 17 and 16 patients, respectively. One month post-diagnosis, mortality was 26% and was associated with the presence of mucositis (P = 0.034). Conclusions: Our study shows that Rhodotorula spp should be considered as aetiologic agents of breakthrough infections in acute leukaemia patients with a CVC, mucositis, who receive prophylaxis with azoles, including posaconazole, and/or undergo alloSCT. Prompt measures, such as L-AmB administration and CVC removal, should be carried out to avoid the high mortality risk of Rhodotorula infections.
ISSN: 14390507
Appears in Collections:Scopus 2018

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