Do high MICs predict the outcome in invasive fusariosis?

dc.contributor.author

Nucci, Marcio

dc.contributor.author

Jenks, Jeffrey

dc.contributor.author

Thompson, George R

dc.contributor.author

Hoenigl, Martin

dc.contributor.author

Dos Santos, Marielle Camargo

dc.contributor.author

Forghieri, Fabio

dc.contributor.author

Rico, Juan Carlos

dc.contributor.author

Bonuomo, Valentina

dc.contributor.author

López-Soria, Leyre

dc.contributor.author

Lass-Flörl, Cornelia

dc.contributor.author

Candoni, Anna

dc.contributor.author

Garcia-Vidal, Carolina

dc.contributor.author

Cattaneo, Chiara

dc.contributor.author

Buil, Jochem

dc.contributor.author

Rabagliati, Ricardo

dc.contributor.author

Roiz, Maria Pia

dc.contributor.author

Gudiol, Carlota

dc.contributor.author

Fracchiolla, Nicola

dc.contributor.author

Campos-Herrero, Maria Isolina

dc.contributor.author

Delia, Mario

dc.contributor.author

Farina, Francesca

dc.contributor.author

Fortun, Jesus

dc.contributor.author

Nadali, Gianpaolo

dc.contributor.author

Sastre, Enric

dc.contributor.author

Colombo, Arnaldo L

dc.contributor.author

Pérez Nadales, Elena

dc.contributor.author

Alastruey-Izquierdo, Ana

dc.contributor.author

Pagano, Livio

dc.date.accessioned

2023-08-01T17:42:48Z

dc.date.available

2023-08-01T17:42:48Z

dc.date.issued

2021-03

dc.date.updated

2023-08-01T17:42:47Z

dc.description.abstract

Background

Invasive fusariosis (IF) affects mostly severely immunocompromised hosts and is associated with poor outcome. Since Fusarium species exhibit high MICs for most antifungal agents, this could explain the poor prognosis. However, a clear-cut correlation between MIC and outcome has not been established.

Objective

To evaluate the correlation between MIC and outcome (6 week death rate) in patients with IF.

Methods

We performed a multicentre retrospective study of patients with IF who received treatment and had MIC levels determined by EUCAST or CLSI for the drug(s) used during treatment. We compared the MIC50 and MIC distribution among survivors and patients who died within 6 weeks from the diagnosis of IF.

Results

Among 88 patients with IF, 74 had haematological diseases. Primary treatment was monotherapy in 52 patients (voriconazole in 27) and combination therapy in 36 patients (liposomal amphotericin B + voriconazole in 23). The MIC50 and range for the five most frequent agents tested were: voriconazole 8 mg/L (range 0.5-64), amphotericin B 2 mg/L (range 0.25-64), posaconazole 16 mg/L (range 0.5-64), itraconazole 32 mg/L (range 4-64), and isavuconazole 32 mg/L (range 8-64). There was no difference in MIC50 and MIC distribution among survivors and patients who died. By contrast, persistent neutropenia and receipt of corticosteroids were strong predictors of 6 week mortality.

Conclusions

Our study did not show any correlation between MIC and mortality at 6 weeks in patients with IF.
dc.identifier

6039361

dc.identifier.issn

0305-7453

dc.identifier.issn

1460-2091

dc.identifier.uri

https://hdl.handle.net/10161/28608

dc.language

eng

dc.publisher

Oxford University Press (OUP)

dc.relation.ispartof

The Journal of antimicrobial chemotherapy

dc.relation.isversionof

10.1093/jac/dkaa516

dc.subject

Humans

dc.subject

Itraconazole

dc.subject

Antifungal Agents

dc.subject

Microbial Sensitivity Tests

dc.subject

Retrospective Studies

dc.subject

Fusariosis

dc.subject

Voriconazole

dc.title

Do high MICs predict the outcome in invasive fusariosis?

dc.type

Journal article

duke.contributor.orcid

Jenks, Jeffrey|0000-0001-6632-9587

pubs.begin-page

1063

pubs.end-page

1069

pubs.issue

4

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Medicine

pubs.organisational-group

Medicine, Infectious Diseases

pubs.publication-status

Published

pubs.volume

76

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
JAC_Nucci_2020.pdf
Size:
499.87 KB
Format:
Adobe Portable Document Format