Background: Invasive fungal infection (IFI) is associated with high morbidity and high mortality in hematopoietic\r\nstem cell transplantation (HSCT) patientsThe purpose of this study was to assess the characteristics and outcomes\r\nof HSCT patients with IFIs who are undergoing MV at a single institution in Taiwan.\r\nMethods: We performed an observational retrospective analysis of IFIs in HSCT patients undergoing mechanical\r\nventilation (MV) in an intensive care unit (ICU) from the year 2000 to 2009. The characteristics of these HSCT\r\npatients and risk factors related to IFIs were evaluated. The status of discharge, length of ICU stay, date of death\r\nand cause of death were also recorded.\r\nResults: There were 326 HSCT patients at the Linkou Chang-Gung Memorial Hospital (Taipei, Taiwan) during the\r\nstudy period. Sixty of these patients (18%) were transferred to the ICU and placed on mechanical ventilators. A\r\ntotal of 20 of these 60 patients (33%) had IFIs. Multivariate analysis indicated that independent risk factors for IFI\r\nwere admission to an ICU more than 40 days after HSCT, graft versus host disease (GVHD), and high dose\r\ncorticosteroid (p < 0.01 for all). The overall ICU mortality rate was 88% (53 of 60 patients), and was not significantly\r\ndifferent for patients with IFIs (85%) and those without IFIs (90%, p = 0.676).\r\nConclusion: There was a high incidence of IFIs in HSCT patients requiring MV in the ICU in our study cohort. The\r\nindependent risk factors for IFI are ICU admission more than 40 days after HSCT, GVHD, and use of high-dose\r\ncorticosteroid.
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