Invasive aspergillosis due to Aspergillus section Usti: a multicenter retrospective study.

Details

Serval ID
serval:BIB_102BDCBA5418
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Invasive aspergillosis due to Aspergillus section Usti: a multicenter retrospective study.
Journal
Clinical infectious diseases
Author(s)
Glampedakis E., Cassaing S., Fekkar A., Dannaoui E., Bougnoux M.E., Bretagne S., Neofytos D., Schreiber P.W., Hennequin C., Morio F., Shadrivova O., Bongomin F., Fernández-Ruiz M., Bellanger A.P., Arikan-Akdagli S., Erard V., Aigner M., Paolucci M., Khanna N., Charpentier E., Bonnal C., Brun S., Gabriel F., Riat A., Zbinden R., Le Pape P., Klimko N., Lewis R.E., Richardson M., İnkaya A.C., Coste A.T., Bochud P.Y., Lamoth F.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Publication state
Published
Issued date
10/03/2020
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Aspergillus spp. of section Usti (A.ustus) represent a rare cause of invasive aspergillosis (IA). This multicenter study describes the epidemiology and outcome of A. ustus infections.
Patients with A. ustus isolated from any clinical specimen were retrospectively identified in 22 hospitals from 8 countries. When available, isolates were sent for species identification (BenA/CaM sequencing) and antifungal susceptibility testing. Additional cases were identified by review of the literature. Cases were classified as proven/probable IA or no infection, according to standard international criteria.
Clinical report forms were obtained for 90 patients, of which 27 had proven/probable IA. Additional 45 cases were identified from literature review for a total of 72 cases of proven/probable IA. Hematopoietic cell and solid organ transplant recipients accounted for 47% and 33% cases, respectively. Only 8% patients were neutropenic at time of diagnosis. Ongoing anti-mold prophylaxis was present in 47% cases. Pulmonary IA represented 67% cases. Primary or secondary extra-pulmonary sites of infection were observed in 46% cases, with skin being affected in 28% cases. Multiple antifungal drugs were used (consecutively or in combination) in 67% cases. The 24-week mortality rate was 58%. A. calidoustus was the most frequent causal agent. Minimal inhibitory concentrations encompassing 90% isolates (MIC90) were 1, 8, >16 and 4 µg/mL for amphotericin B, voriconazole, posaconazole and isavuconazole, respectively.
Aspergillus ustus IA mainly occurred in non-neutropenic transplant patients and was frequently associated with extra-pulmonary sites of infection. Mortality rate was high and optimal antifungal therapy remains to be defined.
Keywords
Aspergillus calidoustus, Aspergillus insuetus, Aspergillus pseudodeflectus, Aspergillus puniceus, Aspergillus ustus
Pubmed
Create date
25/04/2020 11:17
Last modification date
13/06/2020 5:20
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