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Volume 27, Number 1—January 2021

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 Muñoz, Miguel Salavert Lletí, Antonio Rezusta, Maite Ruiz Pérez de Pipaón, Lucrecia Yáñez, Esperanza Merino, María Isolina Campos-Herrero, José María Costa-Mateo, Jesús Fortún, Tomás García-Lozano, Carolina Garcia-Vidal, Mario Fernández-Ruiz, Ferrán Sánchez-Reus, Carmen Castro-Méndez, Inmaculada Guerrero-Lozano, Pere Soler-Palacín, José María Aguado, Luis Martínez-Martínez, Julian Torre-Cisneros1Comments to Author , Marcio Nucci1, and the Spanish Fusariosis Study Group2
Author affiliations: Spanish Network for Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain (E. Pérez-Nadales, A. Alastruey-Izquierdo, M. Montejo, M. Ruiz Pérez de Pipaón, L. Yáñez, J. Fortún, C. Garcia-Vidal, M. Fernández-Ruiz, I. Guerrero-Lozano, P. Soler-Palacín, J.M. Aguado, L. Martínez-Martínez, J. Torre-Cisneros); Maimonides Biomedical Research Institute of Cordoba, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain (E. Perez-Nadales, M.J. Linares Sicilia, J. M. Costa-Mateo, L. Martínez-Martínez, J. Torre-Cisneros); Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain (A. Alastruey-Izquierdo, J.C. Soto-Debrán); Hospital das Clinicas, Universidade de São Paulo, São Paulo, Brazil (E. Abdala); Hospital Universitario La Paz, Madrid (J. García-Rodríguez); Hospital Universitario Cruces, Baracaldo, Spain (M. Montejo); Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain (P. Muñoz); Hospital Universitario "12 de Octubre," Instituto de Investigación Hospital "12 de Octubre,” Universidad Complutense, Madrid, Spain (M. Fernández-Ruiz, J.M. Aguado); Hospital Universitario y Politécnico La Fe, Valencia, Spain (M. Salavert Lletí); Hospital Universitario Miguel Servet, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain (A. Rezusta); Hospital Universitario Virgen del Rocío, Seville, Spain (M. Ruiz Pérez de Pipaón); Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain (L. Yáñez); Hospital General Universitario de Alicante, Spain (E. Merino); Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain (M. I. Campos-Herrero); Hospital Ramón y Cajal, Madrid (J. Fortún); Fundación Instituto Valenciano de Oncología, Valencia, Spain (T. García-Lozano); Hospital Universitario de Bellvitge, Barcelona, Spain (C. Garcia-Vidal); Hospital de la Santa Creu i Sant Pau, Barcelona (F. Sánchez-Reus); Hospital Universitario Virgen de Valme, Seville (C. Castro-Méndez); Hospital Universitario Puerta del Mar, Cádiz, Spain (I. Guerrero-Lozano); Hospital Universitari Vall d’Hebron, Barcelona (P. Soler-Palacín); Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (M. Nucci)

Main Article

Table 3

Univariate and multivariate Cox regression analyses for 90-day death rate in 50 patients treated for invasive fusariosis, Spain, 2000–2015*

Characteristic Unadjusted hazard ratio (95% CI) p value Adjusted hazard ratio (95% CI) p value
M 1.08 (0.52–2.25) 0.84 0.87 (0.41–1.84) 0.87
0.93 (0.45-1.93)

Median age, y (IQR)
1.00 (0.99–1.01)

Charlson index
1.01 (0.86–1.20)
1.16 (0.96–1.40)
Treatment history (previous 30 d)
Antifungal 1.83 (0.81–4.14) 0.15
0.69 (0.33–1.45)

Neutropenia at onset
3.16 (0.95–10.44)

Neutropenia at the end of follow-up
Nonneutropenia Referent Referent
Recovery from neutropenia 1.47 (0.38–5.69) 0.58 1.91 (0.48–7.64) 0.35
Persistent neutropenia
5.62 (1.65–19.11)
9.27 (2.43–35.42)
Hematologic malignancy 2.44 (0.74–8.06) 0.14
History of hematopoietic stem cell transplant 1.39 (0.65–2.99) 0.4
Fungemia 0.21 (0.03–1.54) 0.13
Disseminated disease
1.90 (0.77–4.67)

Antifungal therapy
Monotherapy with lipid formulation of amphotericin B 1.95 (0.92–4.12) 0.08
Monotherapy with azoles 0.47 (0.19–1.15) 0.10
Combined therapy 1.08 (0.50–2.33) 0.84

*Area under the receiver operating characteristic curve for this model was 0.82.

Main Article

1These senior authors contributed equally to this article.

2Members are listed at the end of this article.

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