TY - JOUR
T1 - Do high MICs predict the outcome in invasive fusariosis?
AU - Pagano, Livio
AU - Nucci, Marcio
AU - Jenks, Jeffrey
AU - Thompson, George R
AU - Hoenigl, Martin
AU - Dos Santos, Marielle Camargo
AU - Forghieri, Fabio
AU - Rico, Juan Carlos
AU - Bonuomo, Valentina
AU - Lopez-Soria, Leyre
AU - Lass-Florl, Cornelia
AU - Candoni, Anna
AU - Garcia-Vidal, Carolina
AU - Cattaneo, Chiara
AU - Buil, Jochem
AU - Rabagliati, Ricardo
AU - Roiz, Maria Pia
AU - Gudiol, Carlota
AU - Fracchiolla, Nicola
AU - Campos-Herrero, Maria Isolina
AU - Delia, Mario
AU - Farina, Francesca
AU - Fortun, Jesus
AU - Nadali, Gianpaolo
AU - Sastre, Enric
AU - Colombo, Arnaldo L
AU - Perez Nadales, Elena
AU - Alastruey-Izquierdo, Ana
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - fusariosis
KW - fusariosis
UR - http://hdl.handle.net/10807/175669
U2 - 10.1093/jac/dkaa516
DO - 10.1093/jac/dkaa516
M3 - Article
VL - 76
SP - 1063
EP - 1069
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
SN - 0305-7453
ER -