Fusarium, Scedosporium and Other Rare Mold Invasive Infections: Over Twenty-Five-Year Experience of a European Tertiary-Care Center

Author:

Ledoux Marie-Pierre1ORCID,Dicop Elise2,Sabou Marcela34,Letscher-Bru Valérie34,Castelain Vincent5ORCID,Danion François67ORCID,Herbrecht Raoul1ORCID

Affiliation:

1. Department of Hematology, Institut de Cancérologie de Strasbourg, 67033 Strasbourg, France

2. Clinics of Oncology, Elsan, 67000 Strasbourg, France

3. Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France

4. Institut de Parasitologie et de Pathologie Tropicale, UR 3073 Pathogens-Host-Arthropods-Vectors Interactions, Université de Strasbourg, 67000 Strasbourg, France

5. Intensive Care Unit, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France

6. Department of Infectious Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France

7. INSERM UMR-S1109, 67000 Strasbourg, France

Abstract

Invasive mold infections (IMD) are an emerging concern due to the growing prevalence of patients at risk, encompassing but not limited to allogeneic hematopoietic stem cell transplant recipients, hematological malignancies patients, solid organ transplant recipients and intensive care unit patients. In contrast with invasive aspergillosis and mucormycosis, other hyalohyphomycoses and phaeohyphomycoses remain poorly known. We conducted a retrospective analysis of the clinical, biological, microbiological and evolutive features of 92 IMD having occurred in patients in our tertiary-care center over more than 25 years. A quarter of these infections were due to multiple molds. Molds involved were Fusarium spp. (36.2% of IMD with a single agent, 43.5% of IMD with multiple agents), followed by Scedosporium spp. (respectively 14.5% and 26.1%) and Alternaria spp. (respectively 13.0% and 8.7%). Mortality at day 84 was higher for Fusarium spp., Scedosporium spp. or multiple pathogens IMD compared with Alternaria or other pathogens (51.7% vs. 17.6%, p < 0.05). Mortality at day 84 was also influenced by host factor: higher among hematology and alloHSCT patients than in other patients (30.6% vs. 20.9% at day 42 and 50.0% vs. 27.9% at day 84, p = 0.041). Better awareness, understanding and treatments are awaited to improve patient prognosis.

Publisher

MDPI AG

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