Clinical and Microbiological Insights Into Invasive Fusariosis Following Allogeneic Hematopoietic Stem Cell Transplantation: A 15-Year Single-Center Analysis - PubMed
3 hours ago
- #antifungal susceptibility
- #invasive fusariosis
- #hematopoietic stem cell transplantation
- The study retrospectively analyzed 17 proven invasive fusariosis (IF) cases among 2359 allogeneic HSCT recipients over 15 years (2010-2024), with an incidence of 7.2 per 1000 transplants.
- Patients with IF were more likely to have prior HSCT (58.8%) and be transplanted in non-complete remission (94.1%). Median onset was 19 days post-transplant, often pre-engraftment (64.7%), with a median neutrophil count of 1/µL at diagnosis.
- Fusarium species identified included F. solani complex (11 cases), F. dimerum complex (4), and F. fujikuroi complex (2). All isolates had high micafungin MECs (>16 µg/mL), amphotericin B MICs of 4 µg/mL, and voriconazole MICs >8 µg/mL.
- Mortality was high, with 82.4% dying by Day 84 and median overall survival of 8 days. Combination therapy with liposomal amphotericin B plus voriconazole and neutrophil recovery were associated with improved survival in univariate analysis.
- Despite antifungal prophylaxis (micafungin, posaconazole, voriconazole), IF remains rare but lethal after allogeneic HSCT, with outcomes not clearly linked to MIC values. Early aggressive therapy and immune recovery may enhance survival.