Diagnosis, Prognostic Factors and Therapeutic Management of Invasive Fungal Infections. The Results of a Cross-Sectional Studyin a Tunisian Hospital

Abstract

Introduction: Invasive fungal infection (IFI) is associated to a high morbidity, mortality and healthcare costs.

Patients and Methods: Our cross-sectional study focuses on patients who developed an IFI and treated with systemic antifungals, over a period of 14 months in a tunisian hospital. Clinico-biological data, risk factors, and therapeutic management were collected and analyzed.

Results and Discussion: We report 51 cases with IFI, aged between 15 and 85 years. 56.9% were hospitalized in intensive care units and nearly 80% already

suffer from other pathologies. Based on the EORTC/MSGERC. criteria and clinical, radiological and biological data, IFIs were classified as follows: 49.3% cases of "proven infection", 10.1% cases of "probable infection" and 17.4% cases of "possible infection". Two risk factors revealed to correlate with a poor prognosis: intubation or invasive ventilation and long-term corticosteroid therapy. C glabrata was the most common isolated species, agent responsible for invasive candidiasis. Resistances for fluconazole were not noticed. The anti-fungals prescribed for management of the IFI were: caspofungin, anidulafungin, voriconazole, amphotericin B and fluconzaole (following de-escalation).

Conclusion: A close multidisciplinary collaboration between clinicians, radiologists, mycologists and pharmacists can improve the prognosis of these infections.