Do high MICs predict the outcome in invasive fusariosis?
| Autor: | Francesca Farina, Gianpaolo Nadali, Chiara Cattaneo, Martin Hoenigl, Valentina Bonuomo, Arnaldo Lopes Colombo, Mario Delia, Juan Carlos Rico, María Isolina Campos-Herrero, Ricardo Rabagliati, Ana Alastruey-Izquierdo, Leyre López-Soria, Maria Pia Roiz, Elena Pérez Nadales, Livio Pagano, Jochem B. Buil, Anna Candoni, Jesús Fortún, Carlota Gudiol, Marcio Nucci, Jeffrey D. Jenks, Nicola Stefano Fracchiolla, Marielle Camargo Dos Santos, Carolina Garcia-Vidal, George Richard Thompson, Enric Sastre, Cornelia Lass-Flörl, Fabio Forghieri |
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| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
Fusariosis medicine.medical_specialty Posaconazole Antifungal Agents Combination therapy Itraconazole lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] Microbial Sensitivity Tests Neutropenia Gastroenterology All institutes and research themes of the Radboud University Medical Center Internal medicine Amphotericin B medicine Humans Pharmacology (medical) Retrospective Studies Pharmacology Voriconazole business.industry Mortality rate medicine.disease Settore MED/15 - MALATTIE DEL SANGUE Infectious Diseases business medicine.drug |
| Zdroj: | Journal of Antimicrobial Chemotherapy, 76, 4, pp. 1063-1069 Journal of Antimicrobial Chemotherapy, 76, 1063-1069 |
| ISSN: | 1460-2091 0305-7453 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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