Epidemiology, treatment options and outcome of invasive infections caused by Aspergillus section Usti

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Serval ID
serval:BIB_D90978096285
Type
PhD thesis: a PhD thesis.
Collection
Publications
Institution
Title
Epidemiology, treatment options and outcome of invasive infections caused by Aspergillus section Usti
Author(s)
GLAMPEDAKIS Emmanouil
Director(s)
Lamoth Frédéric
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2020
Language
english
Abstract
Background. 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.
Methods. Patients with A. ustus isolated from any clinical specimen were retrospectively identified in 22 hospitals from 8 coun- tries. 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.
Results. Clinical report forms were obtained for 90 patients, of whom 27 had proven/probable IA. An additional 45 cases were identified from literature review for a total of 72 cases of proven/probable IA. Hematopoietic cell and solid-organ transplant recipi- ents accounted for 47% and 33% cases, respectively. Only 8% patients were neutropenic at time of diagnosis. Ongoing antimold prophylaxis was present in 47% of cases. Pulmonary IA represented 67% of cases. Primary or secondary extrapulmonary sites of infection were observed in 46% of cases, with skin being affected in 28% of cases. Multiple antifungal drugs were used (consecu- tively or in combination) in 67% of 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.
Conclusions. Aspergillus ustus IA mainly occurred in nonneutropenic transplant patients and was frequently associated with extrapulmonary sites of infection. Mortality rate was high and optimal antifungal therapy remains to be defined.
Keywords
Aspergillus ustus, Aspergillus calidoustus, Aspergillus pseudodeflectus, Aspergillus puniceus, Aspergillus insuetus.
Create date
01/12/2020 12:23
Last modification date
18/12/2020 7:10
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