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Needles in a haystack: Extremely rare invasive fungal infections reported in FungiScopeⓇ-Global Registry for Emerging Fungal Infections
J. Salmanton-García, P. Koehler, A. Kindo, I. Falces-Romero, J. García-Rodríguez, Z. Ráčil, SC. Chen, N. Klimko, G. Desoubeaux, GR. Thompson, MÁ. Benítez-Peñuela, JY. Rodríguez, DC. Sheppard, M. Hoenigl, Y. Le Govic, H. Badali, JW. Baddley, J....
Language English Country Great Britain
Document type Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Antifungal Agents therapeutic use MeSH
- Invasive Fungal Infections * drug therapy epidemiology MeSH
- Humans MeSH
- Mycoses * drug therapy epidemiology MeSH
- Registries MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVES: Emerging invasive fungal infections (IFI) have become a notable challenge. Apart from the more frequently described fusariosis, lomentosporiosis, mucormycosis, scedosporiosis, and certain dematiaceae or yeasts, little is known about extremely rare IFI. METHODS: Extremely rare IFI collected in the FungiScopeⓇ registry were grouped as Dematiaceae, Hypocreales, Saccharomycetales, Eurotiales, Dermatomycetes, Agaricales, and Mucorales. RESULTS: Between 2003 and June 2019, 186 extremely rare IFI were documented in FungiScopeⓇ. Dematiaceae (35.5%), Hypocreales (23.1%), Mucorales (11.8%), and Saccharomycetales (11.3%) caused most IFI. Most patients had an underlying malignancy (38.7%) with acute leukemia accounting for 50% of cancers. Dissemination was observed in 26.9% of the patients. Complete or partial clinical response rate was 68.3%, being highest in Eurotiales (82.4%) and in Agaricales (80.0%). Overall mortality rate was 29.3%, ranging from 11.8% in Eurotiales to 50.0% in Mucorales. CONCLUSIONS: Physicians are confronted with a complex variety of fungal pathogens, for which treatment recommendations are lacking and successful outcome might be incidental. Through an international consortium of physicians and scientists, these cases of extremely rare IFI can be collected to further investigate their epidemiology and eventually identify effective treatment regimens.
Center for Molecular Medicine Cologne University of Cologne Cologne Germany
Centre d'Etude des Pathologies Respiratoires Unité Inserm U1100 Université de Tours Tours France
Clinical Microbiology and Parasitology Department University Hospital La Paz Madrid Spain
Clinical Trials Centre Cologne University of Cologne Cologne Germany
Department of Infectious Diseases Royal Perth Hospital Perth WA Australia
Department of Internal Medicine Hematology and Oncology Masaryk University Brno Czech Republic
Department of Microbiology Faculty of Science and Informatics University of Szeged Szeged Hungary
Department of Microbiology Government Medical College and Hospital Chandigarh India
Department of Microbiology School of Medicine Universidad Autonóma de Nuevo León Nuevo León Mexico
German Centre for Infection Research partner site Bonn Cologne Cologne Germany
Institute for Human Virology University of Maryland School of Medicine Baltimore MD United States
Institute for Medical Microbiology University of Cologne Cologne Germany
Institute for Virology and Microbiology Witten Herdecke University Witten Germany
Institute of Hematology and Blood Transfusion Prague Czech Republic
Institute of Hygiene and Medical Microbiology Medical University of Innsbruck Innsbruck Austria
Laboratory of Antimicrobial Chemotherapy Ion Ionescu de la Brad University Iași Romania
Mechnikov North Western State Medical University St Petersburg Russian Federation
Medical Service Birmingham VA Medical Center AL United States
MTA SZTE Lendület Mycobiome Research Group Szeged Hungary
Parasitologie Mycologie Médecine Tropicale CHU de Tours France
Parasitology Mycology Unit University Hospital Center Fort de France Martinique French West Indies
School of Pathology and Laboratory Medicine University of Western Australia Perth WA Australia
The University of Sydney Westmead Sydney NSW Australia
References provided by Crossref.org
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- $a Salmanton-García, Jon $u University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), Herderstrasse 52-54, 50931 Cologne, Germany. Electronic address: jon.salmanton-garcia@uk-koeln.de
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- $a Needles in a haystack: Extremely rare invasive fungal infections reported in FungiScopeⓇ-Global Registry for Emerging Fungal Infections / $c J. Salmanton-García, P. Koehler, A. Kindo, I. Falces-Romero, J. García-Rodríguez, Z. Ráčil, SC. Chen, N. Klimko, G. Desoubeaux, GR. Thompson, MÁ. Benítez-Peñuela, JY. Rodríguez, DC. Sheppard, M. Hoenigl, Y. Le Govic, H. Badali, JW. Baddley, J. Chander, PR. Ingram, DL. Pakstis, SC. Mellinghoff, S. Atıcı, S. Cesaro, A. Chakrabarti, D. Dupont, GM. González, L. Hatvani, R. Herbrecht, G. Klyasova, C. Lass-Flörl, M. Mareș, K. Mullane, DC. Vinh, H. Wisplinghoff, M. Lackner, OA. Cornely, D. Seidel, ECMM/ISHAM working group
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- $a OBJECTIVES: Emerging invasive fungal infections (IFI) have become a notable challenge. Apart from the more frequently described fusariosis, lomentosporiosis, mucormycosis, scedosporiosis, and certain dematiaceae or yeasts, little is known about extremely rare IFI. METHODS: Extremely rare IFI collected in the FungiScopeⓇ registry were grouped as Dematiaceae, Hypocreales, Saccharomycetales, Eurotiales, Dermatomycetes, Agaricales, and Mucorales. RESULTS: Between 2003 and June 2019, 186 extremely rare IFI were documented in FungiScopeⓇ. Dematiaceae (35.5%), Hypocreales (23.1%), Mucorales (11.8%), and Saccharomycetales (11.3%) caused most IFI. Most patients had an underlying malignancy (38.7%) with acute leukemia accounting for 50% of cancers. Dissemination was observed in 26.9% of the patients. Complete or partial clinical response rate was 68.3%, being highest in Eurotiales (82.4%) and in Agaricales (80.0%). Overall mortality rate was 29.3%, ranging from 11.8% in Eurotiales to 50.0% in Mucorales. CONCLUSIONS: Physicians are confronted with a complex variety of fungal pathogens, for which treatment recommendations are lacking and successful outcome might be incidental. Through an international consortium of physicians and scientists, these cases of extremely rare IFI can be collected to further investigate their epidemiology and eventually identify effective treatment regimens.
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