Prevention and treatment of invasive aspergillosis in Slovenia: data obtained in >OSPIA< observational clinical study

Abstract

Background: Invasive aspergillosis (IA) is a common opportunistic infection in patients with critical neutropenia. Mostly, patients are located on hematological wards. In Slovenija, because of unsuitable hospital enviroment the problem of IA is huge. With clinical observational study OSPIA (»Observational Study of Patients with Invasive Aspergillosis«) we tried to evaluate prevention, diagnostics and treatment of IA. Methods: During three-year period we included 55 patients with IA. Besides the primary disease, we evaluated risk factors, prevention measures, diagnostic approaches and treatment of IA. Results: In most cases, patients had acute leukemia and major risk factor was critical neutropenia. Because of inadequate hospital conditions, almost every patient received prophylaxis with posoconasol. The most frequently used diagnostic procedure is test for galactomannan antigenemia, followed by radiological approach. Most casas were treated with amphothericin, followed with caspofungin. The treatment was not effective in cases of therapy-refractory primary hematological disease. Conclusions: In Slovenia, IA remains a huge problem in patients with critical neutropenia. The primary reason lays in inadequate hospital treatment conditions for hematological patients. The latter we try to mitigate with posoconasole prophylaxis.