Invasive Fusariosis in Nonneutropenic Patients, Spain, 2000-2015

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.

Keywords: Fusarium; Spain; fungal infections; fungi; fusariosis; incidence; invasive fusariosis; mortality; mycotic diseases; neutropenia.

Figure

Adjusted Kaplan-Meier curves obtained from the stratified Cox regression model for 90-day survival in 50 patients treated for invasive fusariosis, Spain, 2000–2015. HR, hazard ratio.