Fusariosis in Mexico: A 10-year retrospective series

Author:

Barragán-Reyes Armando1,Jácome Luis Esaú López2,Perales-Martínez Diana3,Nava-Ruiz Alejandra4,Hernández María de Lourdes García2,Cornejo-Juárez Patricia5,Rincón-Zuno Joaquín6,Camacho Adrián7,Cendejas Rafael Franco8ORCID,Guzmán José M Feliciano4,Rivera-Martínez Norma E9ORCID,Ontañón-Zurita Diego5,Reséndiz-Sánchez Jesús10,Juárez-Hernández Eva11,Aguilar-Zapata Daniel11ORCID

Affiliation:

1. Hospital Médica Sur, Internal medicine department , Mexico City , Mexico

2. Instiuto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Clinical microbiology laboratory. Infectious diseases division , Mexico City , Mexico

3. Hospital Ángeles San Luis, San Luis Potosí, México / Hospital Regional de Alta Especialidad del Bajío, Leon. Infectious diseases and hospital epidemiology division , Mexico

4. Hospital de Especialidades Pediáricas, Pediatric infectious diseases, Tuxtla Gutiérrez , Chiapas , Mexico

5. Instituto Nacional de Cancerología, Infectious diseases division , Mexico City , Mexico

6. Instituto materno Infantil del Estado de México, Infectious diseases department , Toluca , Mexico

7. Hospital Universitario Dr. José Eleuterio González, Hospital epidemiology and infectious diseases division , Monterrey , Mexico

8. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra , Clinical microbiology laboratory. Infectious diseases division. Mexico City , Mexico

9. Hospital regional de alta especialidad de Oaxaca, Infectious diseases division , Oaxaca , Mexico

10. Hospital Infantil de México Federico Gómez , Mexico City , Mexico

11. Hospital Médica Sur, Infectious diseases. Translational Research Unit , Mexico City , Mexico

Abstract

Abstract Fusarium species represent an opportunistic fungal pathogen. The data in Mexico about Fusarium infections in humans are scarce. Here, we present a retrospective series of patients with a confirmed diagnosis of fusariosis in eight different hospitals in Mexico from January 2010 to December 2019. The diagnosis of proven fusariosis was made according to the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium (EORT/MSG) criteria. A total of 49 cases were identified in our series. Most patients had burn injuries (49%), and 37% had hematological malignancies. Most patients had fire injuries (40%), followed by electric injuries (8%), febrile neutropenia (10%), and pancytopenia (6%). Patients had skin and soft tissue involvement in 49%, followed by blood culture isolation and biopsies from different sites of the body (lung, sinuses, bone tissue, and eyes). Febrile neutropenia (10%) and fungemia (8%) were the most common clinical syndromes in immunosuppressed patients. Most patients received monotherapy (67%), where voriconazole was used in 30% of the cases, followed by conventional amphotericin B (16%), and lipidic formulations of amphotericin B in 10% (either liposomal amphotericin B or amphotericin B lipid complex). Combination therapy was used in 20% of the cases, and the most common combination therapy was triazole plus any lipidic formulation of amphotericin B (10%). Mortality related to Fusarium infection occurred in 22% of patients. Fusariosis is a serious threat. Burn injuries and hematologic malignancies represent the most common causes of infection in this small series from Mexico.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,General Medicine

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