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Global Emerging Fungal Infection Registry

Initiated in 2003

Report September 2012

Working group of the

Under the auspices of

Supported by unrestricted grants from Astellas Pharma, Gilead Sciences, Merck and Pfizer

Report September 2012 of 34

Study Coordinators ........................................................................... 3

Introduction .................................................................................... 6

Current Results ............................................................................... 10

Achievements and Goals .................................................................. 17

Presentations 2012, 2011, 2010 ..................................................... 17

Publications ................................................................................. 18

Awards ........................................................................................ 18

Recent Accomplishments ............................................................... 18

2012 Goals .................................................................................. 19

Contact Information ......................................................................... 20

Participating Institutions................................................................... 21


Clinical ID Microbiology Molecular Biology Pharmacology Pathology

Austria

Elisabeth Presterl, MD Allgemeines Krankenhaus -Universitätskliniken Wien Währinger Gürtel 18-20 1090 Wien T +43-1-40400-4440 F +43-1-4400-4418 elisabeth.presterl@meduni wien.ac.at

Cornelia Lass-Flörl, MD Institute of Hygiene, Microbiology and Social Medicine Universität Innsbruck Fritz-Pregl-Str. 3 6020 Innsbruck T +43-512-9003-70725 F +43-512-9003-73700 [email protected]

Walter Buzina, MD Institut für Hygiene Medizinische Universität Universitätsplatz 4 8010 Graz T +43-316-380-7719 F +43-316-380-9648 [email protected]

Ulrich Strasser. MD Institut für Pathologie Medizinische Universität Innsbruck Müllerstr. 44 A-6020 Innsbruck T +43-512-9003-71304 F +43-512-582-088 [email protected]

Brazil

Marcio Nucci, MD Hospital Universitário Universidade Federal do Rio de Janeiro Av. Brigadeiro Trompovsky S/N 21941-590 Rio de Janeiro T +55-21-2562-2463 F +55-21-2562-2460 [email protected]

Czech Republic

Zdeněk Ráčil, MD Dept. of Internal Medicine University Hospital Brno Jihlavska 20, 62500 Brno T +420-53223-2830/3642 F +420-53223-3603 [email protected]

Iva Kocmanova, MD Dept. of Microbiology University Hospital Brno, Jihlavska 20, 62500 Brno T +420 53223 2974 [email protected]

Martina Lengerova, MD Dept. of Internal Medicine Hemato-Oncology University Hospital Brno Jihlavska 20, 62500 Brno T +420 53223 3642 [email protected]

Mojmir Moulis, MD Dept. of Pathology University Hospital Brno Jihlavska 20, 62500 Brno T +420 53223 1111 [email protected]

Ludmila Malaskova, MD Dept. of Biochemistery University Hospital Brno Jihlavska 20, 62500 Brno T. +420 53223 3073 [email protected]

mailto:[email protected]













Germany

Oliver A. Cornely, MD, FIDSA, FACP Klinikum der Universität Klinik I für Innere Medizin 50924 Köln T +49-221-478-6494 F +49-221-478-3611 [email protected]

Guido Fischer, MS, PhD Landesgesundheitsamt Baden-Württemberg Referat 96 - Arbeitsmedizin, umweltbezogener Gesundheitsschutz Nordbahnhofstraße 135 70191 Stuttgart T +49-711-904-39620 F +49-711-904-37105 [email protected]

Ralf Bialek, MD MVZ Labor Dr. Krause Steenbeker Weg 25 24106 Kiel T +49-431-388-252 [email protected]

Carsten Müller, MD Klinikum der Universität Institut für Pharmakologie 50924 Köln T +49-221-478-5066 F +49 221 478 7184 [email protected]

Axel Hamprecht, MD Klinikum der Universität Institut f. Mikrobiologie, Immunologie u. Hygiene Goldenfelsstr. 19-2 D-50935 Köln T +49-221-478 32023 F +49-(0)221-478-32134 [email protected]

India

Anupma Jyoti Kindo, MD Dept. of Microbiology Sri Ramachandra Medical College/Research Institute No.1, Ramachandra Nagar Porur, Chennai, 600 116 T +91-944-523-9196 F +91 44 2476 5608 [email protected]







Study Coordinators


Israel

Morad Wattad, MD Rabin Medical Center Infectious Diseases Unit 39 Jabotinski St. 49100 Petah Tikva T +972-3-937-7377 F +972-3-937-6365 [email protected]

Italy

Livio Pagano, MD Dipartimento di Ematologia Universita Cattolica del Sacro Cuore (Roma) Largo Francesco Vito 1 00168 Roma T +39-6-355-03953 F +39-630-51343 [email protected]

Maurizio Sanguinetti, MD Istituto di Microbiologia (Roma) Università Cattolica del Sacro Cuore Largo Francesco Vito 1 00168 Roma T +39-06-3015-4964 F +39-06-3051-152 [email protected]

Annamaria Tortorano, MD Dip. Sanità Pubblica-Microbiologia-Virologia Milano Università di Milano Via Pascal, 36/38 20133 Milano T +39-2-503-15145 F +39-2-503-15146 [email protected]

Andrea Novelli, MD Dipartimento di Farmacologia Università degli Studi di Firenze Viale Pieraccini, 6 50139 Firenze T +39-055-4271-286 F +39-055-4271-280 [email protected]

Gianluigi Vago, MD Department of Clinical Sciences Luigi Sacco Hospital University of Milan Via Pascal, 36/38 20133 Milano T +39 0285994869 F +39 0285994800 [email protected]

Turkey

Sevtap Arikan-Akdagli, MD Mycology Laboratory (Ankara) Hacettepe University 06100 Ankara F +90 (312) 3115250 [email protected]









Introduction The incidence of invasive fungal infections (IFI) is increasing in all parts of the world. The etiology for this ongoing epidemiological development is not completely understood. However, major contributing factors are the increasing number of transplantation procedures undertaken around the world (estimated at 500,000 per year), a widening of the indications for intensive chemotherapy, and the growing number of other clinical conditions requiring immunosuppressive treatment.

Therapeutic standards have been developed for the most frequent IFI, i.e. candidiasis, aspergillosis and cryptococcosis. However, the so called “emerging fungi” are also a reason for the increased number of IFIs. Thus, clinicians are now facing infections due to a variety of different fungi without any reliable treatment recommendations and therapeutic decision making is not evidence based. Prevalence of “emerging fungi” is virtually unknown and there is an additional knowledge gap in pathogen biology, since isolates have not been collected systematically.

In order to overcome the lack of knowledge on epidemiology, clinical course, biology and pathomechanisms, and finally to develop an evidence based diagnostic-therapeutic integrated approach of IFI caused by “emerging fungi”, A Global Emerging Fungal Infection Registry – Fungiscope™ has been created.

Fungiscope™ uses a web-based electronic case form accessible via www.fungiscope.net. For inclusion into the registry patients require cultural, histopathological, serological or molecular evidence of IFI and the associated clinical symptoms and signs. The clinical data on underlying disorder and IFI will be collected and stored in an internet-based database. Additionally, the pathogen strains and samples of infected tissue are collected, examined and stored in a bio-bank – the Fungithek. The clinical and biological data are subsequently evaluated and analysed. Figure 1a and b present the data / sample flow and overall project structure. The clinical database and the bio-bank are connected and accessable to the public via a web-based search engine - FungiQuest (figure 2).

In the following report we introduce the most current results and achievements. We also discuss future goals and ongoing developments of the project.


Figure 1a: Project structure


Figure 1b: Material flow


Figure 2: FungiQuest database search engine


Current Results Until now, 299 cases have been documented and considered valid. The most frequently registered pathogens were Mucorales (previously termed Zygomycetes) (n=118; 39.5%), Fusarium spp. (n=51; 17.1%), yeasts (n=43; 14.4%), and Dematiaceae (n=34; 11.4%) followed by Penicillinum spp. / Paecilomyces spp. (n=15; 5.0%) and Scedosporium spp. (n=13; 4.3%) (figure 3). The majority of patients were Caucasian followed by Asian and North/South American Indian origins (figure 4). The contribution of cases by country is shown in figure 5.

Sites of infection differ among pathogens, see figure 6. In patients with invasive mucormycosis, the lungs were the most commonly involved organs with an incidence of 66.9%. Other involved sites were the paranasal sinuses (22.0%), deep soft tissues (13.6%) and the central nervous system (13.6%). Fusarium spp. infections most frequently presented as blood stream infections (51.0%) or skin infections (47.1%). Other commonly affected sites were lungs (35.3%) and deep soft tissues (21.6%). Infections with Dematiaceae mostly involved the eyes, paranasal sinuses, deep soft tissues, and skin (range from 11.8% - 32.4%). By contrast, yeasts were most often diagnosed from blood cultures (approximately 65%) followed by pulmonary infections (30.2%).

The evaluation of risk factors for the development of IFI revealed differences between individual pathogens shown in figure 7. The most common risk factors for developing an infection with Mucorales and Fusarium spp. were chemotherapy (approximately 54%) or haematopoetic stem cell transplantation (HSCT) (approximately 30%) followed by stay at an intensive care unit and diabetes mellitus, with rates of 13.7 – 18.6%.

Chemotherapy was also the most common risk factors in patients presenting with yeast infections (44.2%). In addition, 34.9% of patients were treated in intensive care units. Further risk factors were diabetes mellitus (14%) and solid organ transplantation (14%).

By contrast, patients with a Dematiaceae infection presented most frequently with diabetes mellitus (47.1%) and/or chronic renal disease (17.2%).

Mortality, attributable mortality and response to treatment differed among individual pathogens and are shown in figure 8. The highest overall mortality was observed in patients with mucormycosis (58.5%), followed by patients with yeast (53.5%) and Fusarium spp. infections (47.1%). In more than 70% of cases the cause of death was the fungal infection irrespective of causative species. By contrast, the lowest overall mortality was revealed in patients with Dematiaceae, equaling only 5.9%. None of these deaths was due to the fungal infection. The highest rates of complete and partial remissions were observed in patients with IFI caused by Dematiaceae and Penicillium/Paecilomyces spp (73%). Patients with a Mucorales infection displayed the lowest rate of response to treatment (44.9%).

In conclusion, the clinical relevance of invasive fungal infections by emerging fungi is increasing. In a short time, actual cases from several countries world-wide could be documented and showed a broad spectrum of pathogens. Further investigators and coordinators are encouraged to contribute to the success of Fungiscope™.


Figure 3: Distribution of 299 pathogens by major groups


Figure 4: Ethnicities


Figure 5: Case contributions by country


Figure 6: Risk factors for major groups


Figure 7: Sites of infection for major groups


Figure 8: Outcomes for major groups


Achievements and Goals Presentations 2012, 2011 and 2010

October 19-23, 2012 Annual Congress of the German Society for Hematology and Oncology (DGHO), Stuttgart, Germany

September 9-12, 2012 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), San Francisco, CA, USA

June 23-26, 2012 18th Congress of the International Society for Human and Animal Mycology, Berlin, Germany

April 25-28, 2012 11th Congress of Infectious Diseases and Tropical Medicine, Cologne, Germany

March 31-April 3, 2012 22nd European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), London, UK

January 24-25, 2012 3rd WATL-Congress, Berlin, Germany

October 2-5, 2011 5th Trends in Medical Mycology (TIMM), Valencia, Spain

September 30-Oct. 4, 2011 Annual Congress of the German Society for Hematology and Oncology (DGHO), Basel, Switzerland

September 17-21, 2011 51th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, USA

September 1-3, 2011 45th Congress of the German Society for Mycology (DMykG e.V.), Kiel, Germany

May 7-10, 2011 21st ECCMID/27th ICC, Joint Congress of the European Society of Clinical Microbiology and Infectious Diseases and the International Society of Chemotherapy20th, Milan, Italy

March 31-April 2, 2011 Annual Congress of the German Society for Infectious Diseases (DGI), Leipzig, Germany

October 1-5, 2010 Annual Congress of the German Society for Hematology and Oncology (DGHO), Berlin, Germany

September 12-15, 2010 50th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), MA, Boston, USA

September 9-11, 2010 44th Congress of the German Society for Mycology (DMykG e.V.), Vienna, Austria

June 23-26, 2010 10th Congress of Infectious Diseases and Tropical Medicine, Cologne, Germany

June 18-19, 2010 MSD Workshop „Infektionen in der Hämatologie“, Munich, Germany

May 7-8, 2010 Paul-Ehrlich-Gesellschaft für Chemotherapie e.V., Spring Meeting of the “Sektion Antimykotische Chemotherapie”, Bonn, Germany

April 10-13, 2010 20th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), Vienna, Austria


Publications

August 2012 Christopeit M, Lindner A, Surov A, Weber T, Vehreschild MJ, Bialek R, Schmoll HJ.Right flank pain and high fever in a neutropenic patient with acute lymphoblastic leukaemia. Mycoses 2012, Aug 13. Doi: 10.1111/j.1439-0507.2012.02231.x. Epub ahead of print

October 2011 de Hoog GS, Robert V, Lackner M, Vehreschild MJ, Vehreschild JJ, Symoens F, Göttlich-Fligg E, Garcia-Hermoso D, Harun A, Meyer W, Chen SC, Hamprecht A, Fischer G, Buzina W, Cornely OA, Guarro J, Cano J, Horré R Making moulds meet. Information retrieval as a basis for understanding Pseudallescheria and Scedosporium Mycoses. 2011 Oct;54 Suppl 3:1-4

December 2009 M.J.G.T. Rüping, W.J. Heinz, A.J. Kindo, V. Rickerts, C. Lass-Flörl, C. Beisel, R. Herbrecht, Y. Roth, G. Silling, A.J. Ullmann, K. Borchert, G. Egerer, J. Maertens, G. Maschmeyer, A. Simon, M. Wattad, G. Fischer, J.J. Vehreschild, O.A. Cornely Forty-one Recent Cases of Invasive Zygomycosis from a Global Clinical Registry J Antimicrob Chemother. 2010 Feb;65(2):296-302

July 2008 Rüping M.J.G.T., Albermann N., Ebinger F., Burckhard I., Beisel C., Müller C., Vehreschild J.J., Kochanek M., Fätkenheuer G., Bangard C., Ullmann A.J., Herr W., Kolbe K., Hallek M., Cornely O.A. Posaconazole concentrations in the central nervous system. J Antimicrob Chemother 2008 Dec;62 (6):1468-70

Awards

Young Investigator Award 2010 (Nachwuchsförderpreis) of the German Society for Mycology (DMykG e.V.) awarded to Dr. M.J.G.T. Vehreschild for her work on Fungiscope

Recent Accomplishments

Initiation of the MSG Phaeohyphomycosis Registry by use of the Fungiscope database in October 2012.

Abstract on the Fusarium spp. Infections joint analysis in cooperation with the Brazilian Fusarium spp. Group (Prof. Marcio Nucci, Rio de Janeiro, Brazil) presented as an oral presentation at the ICAAC 2012. Manuscript in preparation.

Newly established cooperation with the Robert Koch Institute in (Dr. Volker Rickerts, Berlin, Germany) for extended diagnostics on paraffin embedded specimens of patients

http://www.ncbi.nlm.nih.gov/pubmed/21995656

http://www.ncbi.nlm.nih.gov/pubmed/21995656


with suspected emerging invasive fungal infections by use of sequencing plus ribosomal RNA FISH

Initiation of an analysis of combination treatment with liposomal Amphotericin B plus posaconazole for mucormycosis infections in co-operation with the SEIFEM study group (Prof. Livio Pagano, Rome, Italy)

Agreement with the ECMM signed to use the Fungiscope clinical database for conducting the ECMM TriReg Study on Trichosporon spp. infections

Database restructuring including:

o Re-evaluation of all cases with respect to infection vs. colonization

o Harmonizing different wording used for documentation

o Structural adjustments facilitating data export and analysis

Initiation of an epidemiological online survey to monitor trends

2012 Goals

Publication of a subset analysis on rare yeasts, including resistance patterns

Publication of a comparison between sequencing and morphological results for the first 100 Fungiscope isolates

Extending the FungiQuest™ platform (online since April 2010):

o Faster inclusion of new cases

o Inclusion of FungiThek / isolate information

o Improved search-engine


Contact Information

Chair:

Oliver A. Cornely, MD, FIDSA, FACP

[email protected]

Coordinating Physicians:

Maria J.G.T. Vehreschild (née Rüping), MD

[email protected]

Kerstin Wahlers, MD

[email protected]

Technical advisor, site operator clinicalsurveys.net:

Jörg J. Vehreschild, MD

[email protected]

Uniklinik Köln

Infectious Diseases – Clinical Trials Unit II

BH E15 R64

Kerpener Strasse 62

50937 Köln

Germany

T +49-221-478-6494

F +49-221-478-3611

www.fungiscope.net





http://www.fungiscope.net/


Participating Institutions

Argentina

El Centro de Internación de FUNDALEU, Departamento Medico, Buenos Aires, Argentina Maria Cecilia Dignani

Instituto Nacional de Enfermedades Infecciosas "Dr. C. G. Malbrán", Buenos Aires, Argentina Susana Cordoba

Centro de Referencia de Micología Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina

Marisa Biasoli

Centro de Trasplante de Médula Ósea de Rosario (CETRAMOR), Rosario, Argentina. José Anibal Cozzi

Australia

Department of Microbiology & Infectious Diseases, Royal Perth Hospital, Perth, Australia Christopher Heath

Austria

Abt. f. Anästhesie und Intensivmedizin, Wilhelminenspital Wien, Wien, Austria Peter Wimmer

Anästhesiologie und Intensivmedizin, Landesklinikum Thermenregion Baden, Baden, Austria Franz Schwameis

Infektionen und Tropenmedizin, Universitätsklinik I für Innere Medizin, Medizinische Universität Wien, Wien, Austria

Christina Kratzer, Elisabeth Presterl

Institut für Anästhesie und Intensivmedizin, Landeskrankenhaus Steyr, Steyr, Austria Achim von Goedecke

Institut für Hygiene, klinische Bakteriologie und Mykologie, Medizinische Universität Graz, Graz, Austria

Walter Buzina

Institut für Hygiene, Mikrobiologie und Sozialmedizin, Medizinische Universität Innsbruck, Innsbruck, Austria

Cornelia Lass-Flörl, Anna Huppert, Isabella Schalk

Institut für Pathologie, Medizinische Universität Innsbruck, Innsbruck, Austria Ulrich Strasser

Kinder- Herzzentrum Linz, Allgemeines Krankenhaus Linz, Linz, Austria Werner Moosbauer

Klinik für Anästhesiologie, Wagner-Jauregg Nervenklinik, Linz, Austria Udo Illievich

Klinik für Pneumologie, Inselspital, Universitätsspital Bern, Bern, Austria Sebastian Ott


Krankenhaushygiene, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria Ulrich Zerlauth

Section of Infectious Diseases, Department of Medicine, Medical University of Graz, Austria Martin Hoenigl

Universitätsinstitut für Medizinische Mikrobiologie, Hygiene und Infektiologie - SALK Labor GmbH, Salzberger Universitätsklinikum, Salzberg, Austria

Markus Hell

Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Austria Katharina Pfistershammer

Belgium

University Hospital Gasthuisberg , Leuven, Belgium Katrien Lagrou, Johan, Maertens, Isabel Spriet

Brazil

Hematology and Mycology Laboratory, Hospital Universitário Clementino Fraga, UFRJ, Rio de Janeiro, Brazil

Marcio Nucci

Infection Control Dept., Santa Casa Complexo Hospitalar, Universidade Federal do Rio Grande do Sul, Brazil

Alessandro Pasqualotto

Laboratory of Mycology, Hospital das Clinicas, Federal University of Paraná, Curitiba, Brazil Flávio de Queiroz Telles

Serviço de Oncohematologia / TMO, Hospital Univ. Prof. Edgard Santos - UFBA, Salvador, Bahia, Brazil

Marco Aurélio Salvino, Monica Botura

Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil Denise Pereira

Canada

Department of Medicine, Peter Lougheed Center, Calgary, Canada Andrew Johnson

Departments of Medicine & Microbiology and Immunology, McGill University, Montreal, Canada

Don Sheppard

Microbiology and Infectious Diseases, SMBD - Jewish General Hospital, Montreal, Canada Mark Miller

Service de Maladies Infectieuses, Département de Pédiatrie, McGill University, Montreal, Canada

Philipe Ovetchkine

Laboratoire de santé publique du Quebec, Secteur Mycologie, Sainte-Anne-de Bellevue Philippe Dufresne


(Quebec), Canada

Chile

Facultad de Medicina, Universidad de Valparaíso, Chile Thomas Weitzel

Unidad de Infectología, Clínica Alemana, Santiago de Chile, Chile Luis Thompson

China

Changhai Hospital, Department of Hematology, Shanghai P.R., China Jian-Min Yang

Institute of Hematology, Peking University People's Hospital, Beijing, China Feng-Rong Wang

Department of Hematology, Guangdong General Hospital, Guangdong, China Xin Du

Zhejiang University, School of Medicine, The First Affiliated Hospital, Bone Marrow Transplant Center, Hangzhou Zeijiang, China

He Huang

Columbia

Conjunto Residencial Montevideo, Medellin, Columbia Angela Restrepo, Angela Tobón

Croatia

Division of Haematology, Zagreb University Hospital Centre, Zagreb, Croatia Nemet Damir, Vrohvac Radovan

Cuba

Instituto de Hematologia e Imunologia, Habana, Cuba Alberto Arencibia Núñez

Czech Republic

Dept. of Internal Medicine, Hematology/Oncology, Faculty Hospital Brno, Brno, Czech Republic

Zdenek Racil

Dept. of Microbiology, Faculty of Medicine, Palacky University, Olomouc, Czech Republic Petr Hamal

Denmark

Dept. of Hematology, Copenhagen University Hospital, Copenhagen, Denmark Jannik Helweg-Larsen, Emil


Hermansen

France

Département d'Hématologie, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, and Université Denis Diderot, Paris, France

Emmanuel Raffoux, Patricia Ribaud

Hematology and Oncology, University Hospital of Strasbourg Hautepierre Hospital, Strasbourg, France

Raoul Herbrecht

Germany

Abteilung für Hämatologie, Onkologie und Rheumatologie, Universitätsklinikum Heidelberg, Heidelberg, Germany

Johann Wilhelm Schier

Abteilung für Innere Medizin, Hämatologie u.Onkologie, Klinikum Frankfurt, Germany Michael Kiehl

Abteilung für Kinder- und Jugendmedizin, Marienhospital Witten, Witten, Germany Bahman Gharavi

Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians-Universität München, Muenchen, Germany

Thomas Loescher

Dermatologie, Krankenhaus Dresden-Friedrichstadt, Dresden, Germany Gesina Hansel

Division of Clinical Infectious Diseases, Medical Clinic, Research Center Borstel, Borstel, Germany

Christoph Lange

Gastroenterologie & Infektiologie, St. Josef Hospital, Klinikum der Ruhr-Universität Bochum, Bochum, Germany

Renate Schlottmann

Abt. Hämatologie und Onkologie, Georg-August-Universität, Goettingen, Germany Silke Neumann

Hämatologie / Internist. Onkologie, Uniklinik Erlangen, Erlangen, Germany Wolf Rösler

Hämatologie und Onkologie, Klinikum Ernst von Bergmann, Potsdam, Germany Angelika Gerhardt, Georg Maschmeyer

Hämatologie und Onkologie, Medizinische Klinik I, Kliniken Sindelfingen, Sindelfingen, Germany

Stefan Neuburger

Hämatologie und Onkologie, Universitätsklinikum Freiburg, Freiburg, Germany Hartmut Bertz, Werner C. Neubauer

Hämatologie/Onkologie/Immunologie/Rheumatologie, Klinikum Schwäbisch Gmünd, Holger Hebart


Stauferklinik, Mutlangen, Germany

HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany Katrin Gollner, Kathrin Scheckenbach

II. Medizinische Klinik, Einheit für Stammzelltransplantation, Klinikum Augsburg, Augsburg Christoph Schmid

III. Medizinische Klinik, Universitätsklinikum Mannheim , Mannheim, Germany Dieter Buchheidt, Anne Dietz

Infektiologikum Frankfurt, Frankfurt, Deutschland Gaby Knecht

Institut für Infektiologie, Asklepios Klinik St. Georg, Hamburg, Germany M. Sabranski

Institut für Medizinische Mikrobiologie und Hygiene, Universität Lübeck, Lübeck, Germany Jan Rupp

Institut für Medizinische Mikrobiologie, Universitätskliniken Göttingen, Göttingen, Deutschland

Uwe Groß

Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig, Germany Claudia Wickenhauser

Institut für Tropenmedizin, Universitätsklinikum Düsseldorf, Düsseldorf, Germany Stefan Reuter

Interdisziplinäres Zentrum für Palliativmedizin, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany

Sabine Mousset

Kinderkardiologie und Pädiatrische Intensivmedizin, Klinikum der Universität München-Großhadern, München, Germany

Markus Loeff

Klinik III für Innere Medizin, Uniklinik Ulm, Ulm, Germany Georg Härter

Klinik f. Hämato-Onkologie, Klinikum Harlaching, Städtisches Klinikum München GmbH, München, Germany

Meinolf Karthaus, Xavier Schiel

Klinik für Anaesthesiologie und Operative Intensivmedizin, Klinikum Konstanz, Konstanz, Germany

Wolfgang Krüger

Klinik für Dermatologie, University of Tübingen, Tübingen, Germany Sybille Schmidt, Martin Schaller

Klinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum der Universität München-Großhadern, München, Germany

Robert Guerkov

Klinik für Hämatologie und Onkologie, Vivantes Krankenhaus, Berlin, Germany Jörg Beyer, Markus Müller


Klinik für Hämatologie, Onkologie & Palliativmedizin, Städt. Kliniken Bielefeld gem.GmbH, Bielefeld, Germany

Martin Görner

Klinik für Hämatologie, Onkologie und Klin. Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

Thomas Schröder

Klinik für Hämatologie/Internistische Onkologie und Stammzelltransplantation, Kliniken Essen Süd, Essen, Germany

Mohammed Wattad

Klinik für Infektiologie und Tropenmedizin, LMU, München, Germany Thomas Loescher

Klinik für Innere Medizin IV, Onkologie und Hämatologie, Martin-Luther-University Halle-Wittenberg, Halle, Germany

Maximilian Christopeit, Hans-Heinrich Wolf

Klinik für Knochenmarktransplantation, Universitätsklinikum Essen, Essen, Germany Rudolf Trenschel

Klinik für Neonatologie, Universität zu Bonn, Bonn, Germany Cornelia Graef

Klinik für Nephrologie, Universitätsklinikum Essen, Essen, Germany Oliver Witzke

Klinik für Neurochirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany Olaf Süss

Klinik für Neurologie, Helios-Klinikum Berlin-Buch, Berlin, Germany Franz-Josef Dieste

Klinik für Innere Medizin II, Sektion Infektiologie, Universitätsklinikum Jena, Jena, Germany Matthias Pletz

Klinik I für Innere Medizin, Uniklinik Köln, Köln, Germany

Oliver Cornely, Fedja Farowski, Maria Vehreschild, Jörg Janne Vehreschild, Kerstin Wahlers

Klinik und Poliklinik für Innere Medizin C, Hämatologie und Onkologie - Transplantationszentrum Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany

William Krüger,

Katrin Schulz

Klinik und Poliklinik für Innere Medizin, Abteilung für Hämatologie und Onkologie, Universitätsklinikum Rostock, Rostock, Germany

Kersten Borchert, Lena Diestel, Michael Schmitt

Klinik und Poliklinik für Orthopädie, Uniklinik Köln, Köln, Germany Rolf Sobottke

Klinik und Poliklinik für Kinderheilkunde – Pädiatrische Hämatologie/Onkologie - Uniklinik Münster, Münster, Germany

Andreas Groll Jörg Ritter


Klinikum Dortmund Nord, Abteilung Pneumologie/Infektiologie, Dortmund, Germany Bernhard Schaaf, Stefanie Später, Greta Ullrich

Klinikum Neuperlach, Medizinische Klinik IV, München, Germany Meinolf Karthaus

Medizinische Klinik 5 – Hämatologie und Internistische Onkologie, Uniklinik Erlangen, Erlangen, Germany

Stefan Kallert, Stefan Krause

Medizinische Klinik 5 – Hämatologie und Internistische Onkologie, University of Witten/Herdecke, Köln, Germany

Stefan Sauerland

Medizinische Klinik A, KMT-Zentrum, Uniklinik Münster, Münster, Germany Gerda Silling

Medizinische Klinik I, Klinikum Bremen-Mitte, Bremen, Germany Henrike Thomssen

Medizinische Klinik III, Klinikum der Universität München-Großhadern, München, Germany Helmut Ostermann Lisa Peterson

Medizinische Klinik und Poliklinik I, Uniklinik Dresden, Dresden, Germany Ulrich Schuler

Medizinische Klinik und Poliklinik II, Charité-Universitätsmedizin Berlin, Berlin, Germany Markus Ruhnke

Medizinische Klinik und Poliklinik II, Universität Würzburg, Würzburg, Germany

Werner Heinz, Jürgen Löffler, Hartwig Klinker, Bhanu Sinha, Andrew Ullmann

Medizinische Klinik und Poliklinik II, Universitätsklinikum Schleswig-Holstein, Kiel, Germany Heinz-A. Horst

Medizinische Klinik und Poliklinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany Gerlinde Egerer

Medizinische Poliklinik, Klinikum der Universität München-Großhadern, Müuenchen, Germany

Johannes Bogner

MVZ Labor Dr. Krause und Kollegen, Kiel, Germany Ralf Bialek

Mykologisches Labor, Krankenhaus Dresden-Friedrichstadt, Dresden, Germany Irina Vennewald

Onkologikum Frankfurt, Frankfurt, Germany Angelika Böhme

Pädiatrische Hämatologie und Onkologie Infektiologie, Zentrum der Kinderheilkunde, Universität zu Bonn, Bonn, Germany

Arne Simon

Rheumatologische Ambulanz, Sana Rheumazentrum Rheinland-Pfalz AG, Bad Kreuznach, Deutschland

Eckhard Weber


Robert Koch Institut, Abteilung für Infektionskrankheiten,Berlin, Germany Volker Rickerts

Universitätsklinikum Freiburg, Freiburg, Germany Helmut Lang

Zentrum für Infektiologie und Reisemedizin, Universitätsklinikum Freiburg, Freiburg, Germany

Dirk Wagner

Zentrum für Kinder- und Jugendmedizin, Klinik III, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany

Thomas Lehrnbecher

Institut für Hygiene, Kliniken der Stadt Köln, Krankenhaus Merheim, Köln, Germany Frauke Mattner

Institut für Medizinische Mikrobiologie, Universitätsklinikum Essen, Essen, Germany Jörg Steinmann

Greece

1st Department of Propaedeutic Medicine, Athens University, Athens, Greece Anna Skiada

Cystic Fibrosis Department, Aghia Sophia Children´s Hospital, Athens, Greece Stavros Doudounakis

Infectious Diseases and Antimicrobial Chemotherapy Research Laboratory, Athens University, Athens, Greece

George L. Petrikkos

Laboratory for Clinical Microbiology, Attikon University General Hospital, Athens, Greece Joseph Meletiadis

Hungary

Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary

Lorant Hatvani

India

Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Arunaloke Chakrabarti

Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Ritesh Agarwal

Dept. of Microbiology, Centre for Basic Sciences, Kasturba Medical College, Manipal University, Manipal, India

Prakash Yegneswaran

Indonesia

Department of Internal Medicine University of Indonesia, Faculty of Medicine University of Indonesia, Mangunkusumo Hospital, Jakarta, Indonesia

Erni J Nelwan


Ireland

Dept. of Bacteriology, Belfast City Hospital, Belfast, Ireland John E. Moore

Trinity College, Dublin Saint James Hospital, Dublin, Ireland Thomas Rogers

Israel

Department of Otolaryngology – Head & Neck Surgery, Edith Wolfson Medical Center, Holon, Israel

Yehudah Roth

Hadassah University Medical Center, Jerusalem, Israel Maya Korem

Infectious Diseases Unit, Rabin Medical Center, Petah Tikva, Israel Morad Wattad

Sheba Medical Center Israel, Tel Aviv, Israel Nathan Keller

Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel Ronen Ben-Ami

Italy

Department of Biomedical Science and Human Oncology — Hygiene Section, University of Bari, Bari, Italy

Maria Teresa Montagna

Dipartimento di Ematologia, Universita Cattolica del Sacro Cuore, Rome, Italy Livio Pagano

Dipartimento di Farmacologia, Università degli Studi di Firenze, Firenze, Italy Andrea Novelli

Divisione di Ematologia e Trapianto di Midollo Osseo, Ospedale San Martino, Genova, Italy Andrea Bacigalupo

Hematology Unit, San Camillo-Forlanini Hospital, Rome, Italy Mariagrazia Garzia

Istituto di Microbiologia, Universita Cattolica del Sacro Cuore, Rome, Italy Maurizio Sanguinetti

Laboratorio di Micologia Medica, Sezione Sanità Pubblica, University of Milan, Milan, Italy Annamaria Tortorano

Oncoematologia Pediatrica, Policlinico G.B. Rossi, Verona, ItalyClinica di Oncoematologia Pediatrica, Azienda Ospedaliera Padova, Padova, Italy

Simone Cesaro

Pathology Unit, Luigi Sacco Hospital, University of Milan, Milan, Italy Gianluigi Vago

Japan

Division of Control and Treatment of Infectious Diseases, Chiba University Hospital, Chiba, Japan

Katsuhiko Kamei, Akira Watanabe


Nagasaki University Hospital, Nagasaki, Japan Shigeru Kohno

Seirei Hamamatsu General Hospital, Shizuoka, Japan Shinichiro Morioka

Korea

Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea Joon Seong Park

Hematology-Oncology Clinic, Hematopoietic Stem Cell Transplantation Center, Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Korea

Hyeon Seok Eom

Kuwait

Microbiology Department, Health Sciences Center, Kuwait, Kuwait Eiman Mokaddas

Lebanon

American University of Beirut Medical Center, Beirut, Lebanon Souha Kanj-Sharara

Lithuania

Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania Marius Miglinas

Vilnius University Hospital, Department of Hematology, Vilnius, Lithuania Indre Klimiene

Mexico

Hospital Civil de Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico, Eduardo Rodriguez-Noriega

Hospital General de Culiacán, Sinaloa, Mexico Ramón Rivas Llamas

IXtlamatia Clinical Research S.A. de C.V, Mexico City, Mexico Miguel Ángel Reséndiz

Netherlands

Department of Medical Microbiology, Canisius-Wilhelmina Hospital, Nijmegen, Netherlands Jacques Meis

University Medical Center Groningen, Groningen, the Netherlands Jan P. Arends

Peru

Hematology/ BMT Department, Rebagliati National Hospital, Lima, Peru Eduardo Fernandez-Vertiz


Portugal

Coimbra University Hospital, Coimbra, Portugal Rui Tome

Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal Rita Caramalho

Romania

Department of Mycology-Mycotoxicology, Universitatea Petre Andrei, Iasi, Romania Mihai Mares

Russia

Department of Clinical Mycology, Allergology and Immunology, St. Petersburg Medical Academy of Postgraduate Education, St. Petersburg, Russia

Nikolay Klimko Sofya Khostelidi

Singapore

Infectious Diseases Care, 03-01 Mount Elizabeth Medical Centre, 228510 Singapore Asok Kurup

National University Health System, University Medicine Center, Division of Infectious Diseases, NUHS Tower Block, Level 10, 119228 Singapore

Chai Louis Yin Ann

National University Health System, University Children\'s Medical Institute, Department of Pediatrics, 119228 Singapore, Singapore

Si Min Chan

Slovakia

National Cancer Institute, Bratislava, Slovakia Lubos Drgona

South Africa

Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa Robert Dunn

Nelson R. Mandela School of Medicine, Pretoria, South Africa Teke Apalata

Spain

Department of Hematology, University Hospital La Fe, Valencia, Spain, Valencia, Spain Rebeca Rodriguez Veiga

Grupo Andaluz de Leucemias Agudas GALA, Hospital Juan Ramón Jiménez-Huelva, Huelva, Spain

Eusebio Martín Chacón

Servicio de Hematología de la Unidad de Consejo y Cuidado Oncológico de Sanitas, Hospital de la Princesa, Madrid, Spain

Rafael de la Cámara

Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla, Spain Martin-Pena


Almudena

Sweden

Clinical Micrbiological Laboratory, Sunderby Hospital, Luleå, Luleå, Sweden Peter Cettner

Switzerland

Abt. für Spitalhygiene und Spitalepidemiologie, Universitätsspital Basel, Basel, Switzerland Andreas Widmer

Division of Infectious Dieseases & Hospital Epidemiology, Universitätsspital Basel, Basel, Switzerland

U. Flueckiger

Medizin I Abteilung für Hämatologie, Universitätsspital Basel, Basel, Switzerland Alois Gratwohl

Institut für Infektionskrankheiten, Bern, Switzerland Stefan Zimmerli

Universitätsklinik für Pneumologie, Inselspital, Universitätsspital Bern, Bern, Switzerland Sebastian Ott

University Hospital Lausanne (CHUV), Lausanne, Switzerland Andrej Trampiz

Taiwan

Far Eastern Memorial Hospital, Taipei, Taiwan Chiaying Liu

Tai-Chen Stem Cell Therapy Center, National Taiwan University, Taipeh, Taiwan Jih-Luh Tang

Division of Infectious Diseases, Department of Internal Medicine, Center For Infection Control, National Taiwan University Hospital, Taipei, Taiwan

Yee-Chun Chen

Thailand

Division of Infectious Diseases and Tropical Medicine, Khon Kaen University, Khon Kaen, Thailand

Ploenchan Chetchotisakd

Turkey

Akdeniz University Medical Faculty, Department of Clinical Microbiology, Antalya, Turkey Dilara Ogunc

Department of Medicine, Section of Infectious Diseases, Hacettepe University Medical School, Ankara, Turkey

Murat Akova, Sevtap Arikan, Omrun Uzun

Division of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey Fatih Demirkan

Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey

Can Boga


Beyoglu Eye Training and Research Hospital, Istanbul, Turkey Serhat Imamoglu

Dokuz Eylul University Hospital, Department of Hematology, Izmir, Turkey Omur Gokmen Sevindik

United Kingdom

Department of Infection, St George's University of London, London, United Kingdom Jon Lambourne

NPHS Microbiology ABM (Swansea and Bridgend), Wales, United Kingdom Nidhika Berry

Princess Royal University Hospital, South London Healthcare NHS Trust, Farnborough Common, Orpington, Kent, United Kingdom

M. Mansour Ceesay

Southern General Hospital, Glasgow, United Kingdom Nitish Khanna

USA

Department of Infectious Diseases, Section of Transplant Infectious Diseases, Medicine Institute and Transplant Center, Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, Ohio, USA

Sherif Beniameen Mossad

Department of Pathology, University of Colorado, Denver, USA Diane Hutchinson

Division of Infectious Diseases, University of Washington Office, Washington, USA Philip Coffin

University of Alabama at Birmingham, Birmingham, USA John Baddley

University of Texas Southwestern Medical Center at Dallas, Dallas, USA Sanjay Revankar

Medical Microbiology Division, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA, USA

Linda Boyken

MiraVista Diagnostics and MiraBella Technologies, Indianapolis, Indiana, USA Patricia Connolly

Division of Medical Microbiology, Department of Pathology The Johns Hopkins University School of Medicine, Baltimore, MD, USA

Sean Zhang

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