Invasive Fusariosis in Nonneutropenic Patients, Spain, 2000–2015
Elena Pérez‐Nadales, Ana Alastruey‐Izquierdo, María José Linares-Sicilia, Juan Carlos Soto-Debrán, Edson Abdala, Julio García‐Rodríguez, Miguel Montejo, Patricia Muñóz, Miguel Salavert Lletí, Antonio Rezusta, Maite Ruiz Pérez de Pipaón, Lucrecia Yáñez, Esperanza Merino, María Isolina Campos-Herrero, José María Costa-Mateo, Jesús Fortün, Tomás García‐Lozano, Carolina García‐Vidal, Mario Fernández‐Ruiz, F Sánchez, Carmen Castro-Méndez, Inmaculada Guerrero-Lozano, Pere Soler‐Palacín, José María Aguado, Luis Martínez-Martínez, Julián Torre-Cisneros, Márcio Nucci, the Spanish Fusariosis Study Group2
Abstract
Invasive fusariosis (IF) is associated with severe neutropenia in patients with concurrent hematologic conditions. We conducted a retrospective observational study to characterize the epidemiology of IF in 18 Spanish hospitals during 2000-2015. In that time, the frequency of IF in nonneutropenic patients increased from 0.08 cases per 100,000 admissions in 2000-2009 to 0.22 cases per 100,000 admissions in 2010-2015. Nonneutropenic IF patients often had nonhematologic conditions, such as chronic cardiac or lung disease, rheumatoid arthritis, history of solid organ transplantation, or localized fusariosis. The 90-day death rate among nonneutropenic patients (28.6%) and patients with resolved neutropenia (38.1%) was similar. However, the death rate among patients with persistent neutropenia (91.3%) was significantly higher. We used a multivariate Cox regression analysis to characterize risk factors for death: persistent neutropenia was the only risk factor for death, regardless of antifungal therapy.