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Chemotherapy and Invasive Fungal Infection
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Chemotherapy and Invasive Fungal Infection

A special issue of Journal of Fungi (ISSN 2309-608X). This special issue belongs to the section "Fungal Pathogenesis and Disease Control".

Deadline for manuscript submissions: closed (1 May 2021) | Viewed by 6318

Special Issue Editor

Prof. Dr. C. Orla Morrissey

E-Mail Website
Guest Editor
Department of Infectious Diseases, Alfred Health and Central Clinical School, Monash University, Melbourne, VIC, Australia
Interests: epidemiology, prevention and diagnosis of fungal infection; host–pathogen interactions; host immune responses; antifungal resistance.

Special Issue Information

Dear Colleagues,

Patients receiving chemotherapy are at risk of developing invasive fungal infection (IFI). The epidemiology is changing with the introduction of new targeted cancer immunotherapies. New diagnostic tests have been developed in recent years and are undergoing evaluation to determine their utility in clinical practice. Antifungal resistance is increasing, indicating the importance of routine antifungal susceptibility testing, therapeutic drug monitoring and the potential for combination antifungal therapy. New antifungal agents are currently being evaluated in trials. Given the recent developments in this area, the purpose of this Special Issue is to highlight these new developments through state-of-the-art reviews and original research articles.

Sincerely,

Prof. Dr. C. Orla Morrissey
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Fungi is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chemotherapy
  • cancer immunotherapy
  • invasive fungal infections
  • new risks
  • prophylaxis
  • diagnosis
  • resistance
  • antifungal therapy
  • therapeutic drug monitoring
  • phase I, II and III trials

Published Papers (3 papers)

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Research

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10 pages, 1089 KiB  
Article
Risk Factors for Mortality in Colombian Patients with Candidemia
by Jorge Alberto Cortés, Anita María Montañez, Ana María Carreño-Gutiérrez, Patricia Reyes, Carlos Hernando Gómez, Angela Pescador, Beatriz Ariza and Fernando Rosso
J. Fungi 2021, 7(6), 442; https://doi.org/10.3390/jof7060442 - 31 May 2021
Cited by 7 | Viewed by 1866
Abstract
The aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility [...] Read more.
The aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility assessments were performed in a reference centre. Demographic, clinical and treatment variables were evaluated for their associations with mortality. A parametric survival regression analysis was used to identify the risk factors associated with mortality. A total of 109 patients with candidemia in four hospitals in Colombia were identified, with a median age of 30 years old. C. parapsilosis was the most frequently identified microorganism (38.5%); the susceptibility of all isolates was high to fluconazole and anidulafungin, except for C. glabrata isolates. The overall mortality was 35.7%, and the risk factors associated with mortality included lack of antifungal treatment (HR 5.5, 95% CI 3.6–11.4), cancer (HR 3.9, 95% CI 2.3–8.0), diabetes (HR 2.5, 95% CI 1.03–6.4), and age (HR 1.13 per every 10 years, 95% CI 1.02–1.24). Catheter removal was associated with a low mortality rate (HR 0.06, 95% CI 0.00–0.49). Prompt antifungal treatment, better glycemic control and catheter removal should be prioritized in the management of candidemia. Full article
(This article belongs to the Special Issue Chemotherapy and Invasive Fungal Infection)
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14 pages, 803 KiB  
Article
Cost-Effectiveness of Serum Galactomannan Surveillance during Mould-Active Antifungal Prophylaxis
by Ai Leng Khoo, Ying Jiao Zhao, Glorijoy Shi En Tan, Monica Teng, Jenny Yap, Paul Anantharajah Tambyah, Chin Hin Ng, Boon Peng Lim and Louis Yi Ann Chai
J. Fungi 2021, 7(6), 417; https://doi.org/10.3390/jof7060417 - 26 May 2021
Cited by 1 | Viewed by 1510
Abstract
Serial galactomannan (GM) monitoring can aid the diagnosis of invasive aspergillosis (IA) and optimise treatment decisions. However, widespread adoption of mould-active prophylaxis has reduced the incidence of IA and challenged its use. We evaluated the cost-effectiveness of prophylaxis-biomarker strategies. A Markov model simulating [...] Read more.
Serial galactomannan (GM) monitoring can aid the diagnosis of invasive aspergillosis (IA) and optimise treatment decisions. However, widespread adoption of mould-active prophylaxis has reduced the incidence of IA and challenged its use. We evaluated the cost-effectiveness of prophylaxis-biomarker strategies. A Markov model simulating high-risk patients undergoing routine GM surveillance with mould-active versus non-mould-active prophylaxis was constructed. The incremental cost for each additional quality-adjusted life-year (QALY) gained over a lifetime horizon was calculated. In 40- and 60-year-old patients receiving mould-active prophylaxis coupled with routine GM surveillance, the total cost accrued was the lowest at SGD 11,227 (USD 8255) and SGD 9234 (USD 6790), respectively, along with higher QALYs gained (5.3272 and 1.1693). This strategy, being less costly and more effective, dominated mould-active prophylaxis with no GM monitoring or GM surveillance during non-mould-active prophylaxis. The prescription of empiric antifungal treatment was influential in the cost-effectiveness. When the GM test sensitivity was reduced from 80% to 30%, as might be anticipated with the use of mould-active prophylactic agents, the conclusion remained unchanged. The likelihood of GM surveillance with concurrent mould-active prophylaxis being cost-effective was 77%. Routine GM surveillance remained cost-effective during mould-active prophylaxis despite lower IA breakthroughs. Cost-saving from reduced empirical antifungal treatment was an important contributing factor. Full article
(This article belongs to the Special Issue Chemotherapy and Invasive Fungal Infection)
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7 pages, 492 KiB  
Case Report
Breakthrough Invasive Fungal Infections in Allogeneic Hematopoietic Stem Cell Transplantation
by Carmine Liberatore, Francesca Farina, Raffaella Greco, Fabio Giglio, Daniela Clerici, Chiara Oltolini, Maria Teresa Lupo Stanghellini, Federica Barzaghi, Paolo Vezzulli, Elena Orsenigo, Consuelo Corti, Fabio Ciceri and Jacopo Peccatori
J. Fungi 2021, 7(5), 347; https://doi.org/10.3390/jof7050347 - 28 Apr 2021
Cited by 5 | Viewed by 2401
Abstract
Despite the recent introduction of mold-active antifungal prophylaxis (MAP), breakthrough invasive fungal infections (b-IFI) still represent a possible complication and a cause of morbidity and mortality in hematological patients and allogeneic hematopoietic stem-cell transplantation recipients (HSCT). Data on incidence and type of b-IFI [...] Read more.
Despite the recent introduction of mold-active antifungal prophylaxis (MAP), breakthrough invasive fungal infections (b-IFI) still represent a possible complication and a cause of morbidity and mortality in hematological patients and allogeneic hematopoietic stem-cell transplantation recipients (HSCT). Data on incidence and type of b-IFI are limited, although they are mainly caused by non-fumigatus Aspergillus and non-Aspergillus molds and seem to depend on specific antifungal prophylaxis and patients’ characteristics. Herein, we described the clinical presentation and management of two cases of rare b-IFI which recently occurred at our institution in patients undergoing HSCT and receiving MAP. The management of b-IFI is challenging due to the lack of data from prospective trials and high mortality rates. A thorough analysis of risk factors, ongoing antifungal prophylaxis, predisposing conditions and local epidemiology should drive the choice of antifungal treatments. Early broad-spectrum preemptive therapy with a lipid formulation of amphotericin-B, in combination with a different mold-active azole plus/minus terbinafine, is advisable. The therapy would cover against rare azole-susceptible and -resistant fungal strains, as well as atypical sites of infections. An aggressive diagnostic work-up is recommended for species identification and subsequent targeted therapy. Full article
(This article belongs to the Special Issue Chemotherapy and Invasive Fungal Infection)
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