Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry
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Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry. / Jenks, Jeffrey D; Seidel, Danila; Cornely, Oliver A; Chen, Sharon; van Hal, Sebastiaan; Kauffman, Carol; Miceli, Marisa H; Heinemann, Melina; Christner, Martin; Jover Sáenz, Alfredo; Burchardt, Alexander; Kemmerling, Björn; Herbrecht, Raoul; Steinmann, Joerg; Shoham, Shmuel; Gräber, Sandra; Pagano, Livio; Deeren, Dries; Slavin, Monica A; Hoenigl, Martin.
In: MYCOSES, Vol. 63, No. 5, 05.2020, p. 437-442.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry
AU - Jenks, Jeffrey D
AU - Seidel, Danila
AU - Cornely, Oliver A
AU - Chen, Sharon
AU - van Hal, Sebastiaan
AU - Kauffman, Carol
AU - Miceli, Marisa H
AU - Heinemann, Melina
AU - Christner, Martin
AU - Jover Sáenz, Alfredo
AU - Burchardt, Alexander
AU - Kemmerling, Björn
AU - Herbrecht, Raoul
AU - Steinmann, Joerg
AU - Shoham, Shmuel
AU - Gräber, Sandra
AU - Pagano, Livio
AU - Deeren, Dries
AU - Slavin, Monica A
AU - Hoenigl, Martin
N1 - © 2020 Blackwell Verlag GmbH.
PY - 2020/5
Y1 - 2020/5
N2 - OBJECTIVES: Invasive fungal infections caused by Lomentospora prolificans are associated with very high mortality rates and can be challenging to treat given pan-drug resistance to available antifungal agents. The objective of this study was to describe the clinical presentation and outcomes in a cohort of patients with invasive L prolificans infections.METHODS: We performed a retrospective review of medical records of patients with invasive L prolificans infection in the FungiScope® registry of rare invasive fungal infections. Patients diagnosed between 01 January 2008 and 09 September 2019 were included in for analysis.RESULTS: The analysis included 41 patients with invasive L prolificans infection from eight different countries. Haematological/oncological malignancies were the most frequent underlying disease (66%), disseminated infection was frequent (61%), and the lung was the most commonly involved organ (44%). Most infections (59%) were breakthrough infections. Progression/deterioration/treatment failure was observed in 23/40 (58%) of patients receiving antifungal therapy. In total, 21/41 (51%) patients, and 77% of patients with underlying haematological/oncological malignancy, had a fatal outcome attributed to invasive fungal infection. Combination antifungal therapy was frequent (24/40) and associated with improved survival. In particular, treatment regimens including terbinafine were significantly associated with higher treatment success at final assessment (P = .012), with a positive trend observed for treatment regimens that included voriconazole (P = .054).CONCLUSIONS: Lomentospora prolificans infections were associated with mortality rates of 77% and above in patients with underlying haematological/oncological malignancies and those with disseminated infections. While combination therapy is the preferred option for now, the hope lies with novel antifungals currently under development.
AB - OBJECTIVES: Invasive fungal infections caused by Lomentospora prolificans are associated with very high mortality rates and can be challenging to treat given pan-drug resistance to available antifungal agents. The objective of this study was to describe the clinical presentation and outcomes in a cohort of patients with invasive L prolificans infections.METHODS: We performed a retrospective review of medical records of patients with invasive L prolificans infection in the FungiScope® registry of rare invasive fungal infections. Patients diagnosed between 01 January 2008 and 09 September 2019 were included in for analysis.RESULTS: The analysis included 41 patients with invasive L prolificans infection from eight different countries. Haematological/oncological malignancies were the most frequent underlying disease (66%), disseminated infection was frequent (61%), and the lung was the most commonly involved organ (44%). Most infections (59%) were breakthrough infections. Progression/deterioration/treatment failure was observed in 23/40 (58%) of patients receiving antifungal therapy. In total, 21/41 (51%) patients, and 77% of patients with underlying haematological/oncological malignancy, had a fatal outcome attributed to invasive fungal infection. Combination antifungal therapy was frequent (24/40) and associated with improved survival. In particular, treatment regimens including terbinafine were significantly associated with higher treatment success at final assessment (P = .012), with a positive trend observed for treatment regimens that included voriconazole (P = .054).CONCLUSIONS: Lomentospora prolificans infections were associated with mortality rates of 77% and above in patients with underlying haematological/oncological malignancies and those with disseminated infections. While combination therapy is the preferred option for now, the hope lies with novel antifungals currently under development.
KW - Aged
KW - Antifungal Agents/therapeutic use
KW - Female
KW - Hematologic Neoplasms/complications
KW - Humans
KW - Internationality
KW - Invasive Fungal Infections/drug therapy
KW - Male
KW - Middle Aged
KW - Registries
KW - Retrospective Studies
KW - Scedosporium/pathogenicity
KW - Treatment Outcome
U2 - 10.1111/myc.13067
DO - 10.1111/myc.13067
M3 - SCORING: Journal article
C2 - 32080902
VL - 63
SP - 437
EP - 442
JO - MYCOSES
JF - MYCOSES
SN - 0933-7407
IS - 5
ER -
