Table 2.
Clinical Characteristics Associated With Invasive Mold Infection Case Status—4 Medical Centers, Houston, Texas, 2016–2018
| Characteristic | All IMI Cases (N = 182) |
Proven/Probable IMI Cases (n = 96) | Surveillance IMI Cases (n = 86) | Non-IMI Cases (n = 355) |
Comparison of Proven/Probable/Surveillance IMI Cases vs Non-IMI Cases | 3-Way Comparisons of Proven/Probable IMI Cases, Surveillance IMI Cases, and Non-IMI Cases | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| OR (95% CI)a | P Value | aOR (95% CI)b | P Value | Pairwise Comparisonc | P Value | |||||
| Host factors | ||||||||||
| ≥1 EORTC/MSG clinical and host factor | 46 (25.3) | 46 (47.9) | 0 (0) | 0 (0) | ∞ (30.51–∞) | <.001 | … | #, $ | <.001 | |
| ≥1 EORTC/MSG clinical factor | 65 (35.7) | 57 (59.4) | 8 (9.3) | 29 (8.2) | 6.25 (3.75–10.53) | <.001 | … | #, $ | <.001 | |
| ≥1 EORTC/MSG host factor | 116 (63.7) | 63 (65.6) | 53 (61.6) | 85 (23.9) | 5.58 (3.72–8.39) | <.001 | … | $, ‡ | <.001 | |
| No EORTC/MSG clinical or host factor | 47 (25.8) | 22 (22.9) | 25 (29.1) | 241 (67.9) | 0.16 (.11–.25) | <.001 | … | $, ‡ | <.001 | |
| Underlying conditions | ||||||||||
| Neutropenia in 30 d before DOId | 37 (20.3) | 26 (31) | 11 (14.5) | 19 (5.4) | 3.72 (1.98–7.14) | <.001 | 1.97 (.89–4.42) | .097 | #, $ | <.001 |
| Lymphopenia in 30 d before DOId | 106 (58.2) | 57 (69.5) | 49 (65.3) | 121 (34.1) | 2.23 (1.44–3.46) | <.001 | 1.74 (1.00–3.02) | .048 | $, ‡ | <.001 |
| Cancer diagnosis in 2 y before DOI | 89 (48.9) | 44 (45.8) | 45 (52.3) | 96 (27) | 2.58 (1.75–3.81) | <.001 | 1.93 (1.05–3.58) | .035 | $, ‡ | <.001 |
| Documentation of HIV diagnosis in 2 y before DOI | 10 (5.5) | 2 (2.1) | 8 (9.3) | 40 (11.3) | 0.46 (.20–.96) | .029 | 0.57 (.23–1.34) | .213 | $ | .023 |
| Pulmonary diagnosis in 2 y before DOI | 77 (42.3) | 33 (34.4) | 44 (51.2) | 140 (39.4) | 1.13 (.77–1.64) | .521 | 1.35 (.79–2.33) | .271 | … | .057 |
| Solid organ or hematologic transplantation in 2 y before DOI | 43 (23.6) | 22 (22.9) | 21 (24.4) | 38 (10.7) | 2.58 (1.55–4.29) | <.001 | 1.50 (.68–3.37) | .317 | $, ‡ | <.001 |
| Surgery in 90 d before DOI | 24 (13.2) | 15 (15.6) | 9 (10.5) | 37 (10.4) | 1.31 (.72–2.33) | .339 | .68 (.31–1.46) | .335 | … | .348 |
| Injury in 90 d before DOI | 15 (8.2) | 8 (8.3) | 7 (8.1) | 24 (6.8) | 1.24 (.59–2.53) | .531 | 2.82 (.69–10.32) | .125 | … | .821 |
| History of CMV infection | 12 (6.6) | 1 (1) | 11 (12.8) | 13 (3.7) | 1.86 (.76–4.52) | .127 | 1.41 (.51–3.94) | .507 | ‡ | <.001 |
| Diabetes in 90 d before DOI | 57 (31.3) | 28 (29.2) | 29 (33.7) | 79 (22.3) | 1.59 (1.04–2.42) | .022 | 1.54 (.89–2.65) | .120 | … | .057 |
| ESRD in 90 d before DOI | 19 (10.4) | 13 (13.5) | 6 (7) | 23 (6.5) | 1.68 (.84–3.33) | .106 | 1.17 (.53–2.57) | .693 | … | .070 |
| Cirrhosis in 2 y before DOI | 10 (5.5) | 9 (9.4) | 1 (1.2) | 13 (3.7) | 1.53 (.59–3.86) | .321 | 1.15 (.37–3.52) | .808 | #, $ | .021 |
| Alcoholism in 2 y before DOI | 12 (6.6) | 9 (9.4) | 3 (3.5) | 28 (7.9) | 0.82 (.37–1.73) | .589 | .68 (.25–1.76) | .436 | … | .276 |
| Smoked tobacco in 1 y before DOI | 22 (12.1) | 15 (15.6) | 7 (8.1) | 54 (15.2) | 0.77 (.43–1.33) | .326 | 1.09 (.53–2.20) | .815 | … | .217 |
| Injury and surgery | … | … | … | … | … | 8.30 (1.35–58.28) | .026 | … | ||
| Injury and lymphopenia | … | … | … | … | … | .43 (.07–2.63) | .359 | … | ||
| Nonantifungal medications | ||||||||||
| Receipt of corticosteroid medication in 90 d before DOId | 118 (64.8) | 65 (69.9) | 53 (64.6) | 125 (35.2) | 3.54 (2.37–5.32) | <.001 | 1.21 (.69–2.11) | .508 | $, ‡ | <.001 |
| Receipt of noncorticosteroid immunosuppressive in 90 d before DOId | 83 (45.6) | 48 (50.5) | 35 (41.7) | 67 (18.9) | 3.52 (2.32–5.34) | <.001 | 1.76 (.91–3.41) | .090 | $, ‡ | <.001 |
| Receipt of TPN in 90 d before DOId | 21 (11.5) | 14 (14.6) | 7 (8.2) | 11 (3.1) | 3.90 (1.74–9.17) | <.001 | 3.46 (1.44–8.96) | .007 | $ | <.001 |
| Receipt of systemic antibiotics in 90 d before DOId | 167 (91.8) | 85 (89.5) | 82 (95.3) | 236 (66.5) | 5.21 (2.84–10.18) | <.001 | 4.40 (1.90–11.60) | .001 | $, ‡ | <.001 |
| Clinical features | ||||||||||
| Any abnormality on CT or MRI in the 7 d before and 30 d after DOId | 139 (76.4) | 76 (79.2) | 63 (73.3) | 162 (45.6) | 3.85 (2.54–5.89) | <.001 | 2.83 (1.56–5.32) | .001 | $, ‡ | <.001 |
| Any abnormality on bronchoscopy in the 7 d before and 30 d after DOId | 65 (35.7) | 27 (60) | 38 (62.3) | 49 (13.8) | 3.46 (2.00–6.00) | <.001 | 3.82 (2.31–6.40) | <.001 | $, ‡ | <.001 |
| Any signs, symptoms, or syndromes in the 30 d before to 60 d after DOId | 174 (95.6) | 94 (97.9) | 80 (93) | 259 (73) | 8.06 (3.79–19.64) | < .001 | 16.85 (3.32–308.44) | .007 | $, ‡ | <.001 |
Data are presented as No. (%) unless otherwise indicated.
Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; CMV, cytomegalovirus; CT, computed tomography; DOI, date of incidence; EORTC/MSG, European Organization for Research and Treatment of Cancer/Mycoses Study Group; ESRD, end-stage renal disease; HIV, human immunodeficiency virus; IMI, invasive mold infection; MRI, magnetic resonance imaging; OR, odds ratio; TPN, total parenteral nutrition.
Univariable logistic regression was used to compare patient characteristics and outcomes to analyze factors associated with IMI case status.
See Supplementary Appendix 6 for variables included in the multivariable regression analyses.
Significant P values for pairwise post hoc tests are indicated by the following symbols: # proven/probable IMI cases versus surveillance IMI cases, $ proven/probable IMI cases versus non-IMI cases, ‡ surveillance IMI cases versus non-IMI cases.
In the multivariable analysis, observations outside the standard binary categories (eg, “no results available”) were removed and were treated as missing.