Rare mould infections caused by Mucorales, Lomentospora prolificans and Fusarium, in San Diego, CA: the role of antifungal combination therapy.
Abstract
Non-Aspergillus invasive mould infections (IMIs) are associated with devastating morbidity
and mortality rates and are increasingly diagnosed in immunocompromised hosts. The
aim of this study was to describe the epidemiology and outcomes of non-Aspergillus
IMIs at a university hospital in San Diego, California, USA. A retrospective chart
review of the medical records of all patients with cultures growing non-Aspergillus
moulds 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) was performed. A total of 23 cases of non-Aspergillus
IMI were identified, including 10 cases of mucormycosis, 8 cases of lomentosporiosis
and 5 cases of fusariosis. Antifungal susceptibility testing was performed for 14
isolates, and 10/11 Fusarium and Lomentospora isolates had minimum inhibitory concentrations
(MICs) of >16 µg/mL for voriconazole and/or posaconazole. 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 study
period. Non-Aspergillus IMIs were detected in patients with various underlying diseases
and were associated with high mortality rates, which was significantly lower in those
who received antifungal combination therapy.
Type
Journal articleSubject
HumansAscomycota
Fusarium
Mucorales
Antifungal Agents
Treatment Outcome
Drug Therapy, Combination
Microbial Sensitivity Tests
Survival Analysis
Retrospective Studies
Adolescent
Adult
Aged
Aged, 80 and over
Middle Aged
California
Female
Male
Young Adult
Invasive Fungal Infections
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https://hdl.handle.net/10161/28628Published Version (Please cite this version)
10.1016/j.ijantimicag.2018.08.005Publication Info
Jenks, Jeffrey D; Reed, Sharon L; Seidel, Danila; Koehler, Philipp; Cornely, Oliver
A; Mehta, Sanjay R; & Hoenigl, Martin (2018). Rare mould infections caused by Mucorales, Lomentospora prolificans and Fusarium,
in San Diego, CA: the role of antifungal combination therapy. International journal of antimicrobial agents, 52(5). pp. 706-712. 10.1016/j.ijantimicag.2018.08.005. Retrieved from https://hdl.handle.net/10161/28628.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Jeffrey Daniel Jenks
Adjunct Associate Professor in the Department of Medicine

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