Clinical characteristics of hematological tumors combined with invasive fusarium infection and strategies for treatment,prevention and control
10.11816/cn.ni.2025-251009
- VernacularTitle:血液系统肿瘤合并侵袭性镰刀菌感染的临床特征及治疗与防控策略
- Author:
Lili DONG
1
;
Ruoqi SHAN
;
Mingmei DU
;
Sai HUANG
;
Qi LEI
;
Liping DOU
;
Meng LI
Author Information
1. 解放军总医院第一医学中心血液科,北京 100853
- Publication Type:Journal Article
- Keywords:
Hematological malignancies;
Fusarium infection;
Microbial metagene sequencing;
Antifungal therapy;
Preventive and control measures
- From:
Chinese Journal of Nosocomiology
2025;35(16):2455-2459
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the clinical characteristics of patients with hematologic tumors combined with Fusarium infection and analyze the prevention and control measures.METHODS Six patients with hematologic neo-plasms combined with Fusarium infection diagnosed at the First Medical Center of the People's Liberation Army General Hospital from Apr.2019 to Dec.2023 were selected as research objects.Through retrospective analysis of patients' clinical data,the clinical manifestations,diagnosis,treatment and prevention strategies of Fusarium in-fection in hematologic neoplasms were analyzed.RESULTS All six patients with hematologic neoplasms combined with Fusarium infection were neutropenic or deficient patients,with main symptoms including moderate fever,painful skin nodules,rash,skin broken and crusted,and scrotal swelling and pain.Patients with severe neutrophil deficiency were susceptible to blood-borne Fusobacterium infections.Four patients had a markedly elevated G-test and Fusorium was first detected by microbiome metagenomic next-generation sequencing(mNGS)in blood,earli-er than traditional pathogenic culture methods.Five patients had Fusarium detected in urine or stool cultures.All six patients received empirical antibacterial and antifungal treatments,but the fungal infection treatment effects were poor.Treatment was adjusted according to the pathogenetic findings,mainly using a combination regimen based on liposomal amphotericin B or posaconazole tablets,with three patients cured and three death.Two pa-tients were from the same ward with a sixteen-day interval.Although no evidence of infection transmission was found,there was still a risk of cross-infection in patients with hematological malignancies and severe immunodefi-ciency.Measures for the prevention and control of hospital-acquired infections were implemented for patients with Fusarium infection and the ward.CONCLUSIONS The clinical manifestations of patients with hematological tumors combined with Fusarium infection are complex and varied with high mortality rates.MNGS testing is valuable in the early diagnosis of Fusarium infection,and it is necessary to explore new treatment options and hospital-ac-quired infectious disease prevention and control measures to improve the prognosis.
