985. Fusarium Infections in Patients with Hematological Malignancies

Abstract

Abstract Background Fusarium is a ubiquitous mold that can cause invasive and disseminated fusariosis in immunosuppressed patients, especially those with hematological malignancies. The risk factors associated with mortality of patients with Fusarium infections have not been adequately assessed in literature. In this study, we sought to explore the characteristics, clinical outcomes, and risk factors for mortality in Fusarium infections in patients with hematological malignancies. Methods This is a retrospective study of adult hematological malignancy patients admitted to surgical/medical wards or critical units at an academic medical center from January 2010 to January 2021 and diagnosed with proven invasive Fusarium infections through positive microbiological culture data from a biopsy, surgical specimen or sterile site. Primary end point was 30-day mortality. Statistical analysis was done using Fischer’s exact test and Mann-Whitney U test. Results 31 patients with hematological malignancies were identified with proven Fusarium infections during the 10-year period (13,390 total unique patients with diagnosis of hematologic malignancies). Two were excluded due to incomplete data. Demographic characteristics, type and status of hematological malignancy, chemotherapy, exposure to steroids, neutropenia, lymphopenia, antifungal prophylaxis, and other factors were analyzed. Mean age at diagnosis was 52.6 years. 16/29 (55.2%) had undergone stem cell transplant prior to infection with median duration of 150.5 days (range 12 to 1503) prior to infection. The most common pathologies were invasive sinusitis and disseminated cutaneous infection in 13/29 (44.8%) patients. Blood culture was positive in 5/29 (17.2%). Overall mortality was 86.2% with 30-day mortality of 44.8% and 1-year mortality of 83%. Death was attributed to fusariosis in 12/25 (48%). Median duration to death was 56 days (range 2 to 1627 days). Risk factors for 30-day mortality were assessed (table 1). The table describes risk factors for 30-day mortaity for fusarium infections in patients with hematological malignancies. statistical analysis done using fischer’s exact test Conclusion Fusarium infections result in morbidity and mortality in patients with hematological malignancies. A variety of host and disease factors dictate eventual outcome of Fusarium infections in these patients. Lack of neutrophil recovery is a significant risk factor for 30-day mortality in this population. Disclosures All Authors: No reported disclosures