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Rare Mold Infections Caused by Mucorales, Lomentospora Prolificans and Fusarium, San Diego: The Role of Antifungal Combination Therapy.
Int J Antimicrob Agents. 2018 Aug 09;:
Authors: Jenks JD, Reed SL, Seidel D, Koehler P, Cornely OA, Mehta SR, Hoenigl M
Abstract
Non-Aspergillus invasive mold infections (IMIs) are associated with devastating morbidity and mortality rates, and are increasingly diagnosed in immunocompromised hosts. The objective of this study was to describe the epidemiology and outcomes of non-Aspergillus IMIs at our university hospital in San Diego, California, United States. We performed a retrospective chart review of medical records of all patients with cultures growing non-Aspergillus molds at the Microbiology Laboratory in the Center for Academic Laboratory Medicine, Department of Pathology, University of California San Diego (UCSD) Health between mid-2014 and mid-2017 (3 year period). A total of 23 cases of non-Aspergillus IMIs were identified, including 10 cases of mucormycosis, 8 cases of lomentosporiosis, and 5 cases of fusariosis. Antifungal susceptibility testing was performed in 14 isolates and 10/11 Fusarium and Lomentospora isolates had MICs >16 µg/mL for voriconazole and/orposaconazole. Overall 180-day mortality was significantly lower among those who received combination antifungal therapy than among those who received single agent therapy [3/13 (23%) vs. 9/10 (90%); p=0.003]. In conclusion, Lomentospora prolificans (35% of non-Aspergillus IMIs), and Fusarium spp. (22%) accounted for high proportions of non-Aspergillus IMIs during the time period. Non-Aspergillus IMIs were detected in patients with various underlying diseases and associated with high mortality rates, which was significantly lower in those who received antifungal combination therapy.
PMID: 30099056 [PubMed - as supplied by publisher]