Needles in a haystack: Extremely rare invasive fungal infections reported in FungiScope?—Global Registry for Emerging Fungal Infections - 31/10/20
Doi : 10.1016/j.jinf.2020.08.015
Jon Salmanton-García a 
, Philipp Koehler a, b, Anupma Kindo c, Iker Falces-Romero d, Julio García-Rodríguez d, Zdeněk Ráčil e, f, g, Sharon C.-A. Chen h, i, Nikolai Klimko j, Guillaume Desoubeaux k, l, George R. Thompson m, n, Miguel-Ángel Benítez-Peñuela o, José-Yesid Rodríguez o, Donald C. Sheppard p, Martin Hoenigl q, r, s, Yohann Le Govic t, Hamid Badali u, John W. Baddley v, w, x, Jagdish Chander y, Paul R. Ingram z, aa, Diana L. Pakstis bb, Sibylle C. Mellinghoff a, Serkan Atıcı cc, Simone Cesaro dd, Arunaloke Chakrabarti ee, Damien Dupont ff, gg, Gloria M. González hh, Lóránt Hatvani ii, jj, Raoul Herbrecht kk, Galina Klyasova ll, Cornelia Lass-Flörl mm, Mihai Mareș nn, Kathleen Mullane oo, Donald C. Vinh pp, Hilmar Wisplinghoff qq, rr, ss, Michaela Lackner mm, Oliver A. Cornely a, tt, uu, vv, Danila Seidel a, ⁎
The FungiScopeⓇ
, Philipp Koehler a, b, Anupma Kindo c, Iker Falces-Romero d, Julio García-Rodríguez d, Zdeněk Ráčil e, f, g, Sharon C.-A. Chen h, i, Nikolai Klimko j, Guillaume Desoubeaux k, l, George R. Thompson m, n, Miguel-Ángel Benítez-Peñuela o, José-Yesid Rodríguez o, Donald C. Sheppard p, Martin Hoenigl q, r, s, Yohann Le Govic t, Hamid Badali u, John W. Baddley v, w, x, Jagdish Chander y, Paul R. Ingram z, aa, Diana L. Pakstis bb, Sibylle C. Mellinghoff a, Serkan Atıcı cc, Simone Cesaro dd, Arunaloke Chakrabarti ee, Damien Dupont ff, gg, Gloria M. González hh, Lóránt Hatvani ii, jj, Raoul Herbrecht kk, Galina Klyasova ll, Cornelia Lass-Flörl mm, Mihai Mareș nn, Kathleen Mullane oo, Donald C. Vinh pp, Hilmar Wisplinghoff qq, rr, ss, Michaela Lackner mm, Oliver A. Cornely a, tt, uu, vv, Danila Seidel a, ⁎ The FungiScopeⓇ
ECMM/ISHAM working group1
On behalf of The FungiScopeⓇ ECMM/ISHAM Working Group.
Barbara D. Alexander, María Almagro-Molto, Eduardo Álvarez-Duarte, Martha Avilés-Robles, Aleksandra Barać, Vanda Chrenková, Patricia Cornejo-Juárez, Nicole Desbois-Nogard, Mario Fernández-Ruiz, Luis Figueira, Jesús García-Martínez, Sandra Gräber, Barbara Graf, Georg Haerter, Shariq Haider, Pamela Hartman, Melina Heinemann, Aamer Ikram, Frédéric Janvier, Jeffrey D. Jenks, Carol Kauffman, Robert Krause, Me-Linh Luong, Shruti Malik, Vincent Marconi, Rodrigo Martino, Sanjay R. Mehta, Lisa Meintker, Andrea Mocná, Michele I. Morris, Alessandro C. Pasqualotto, Atul Patel, Olaf Penack, Nicolas Pichon, Mathias W. Pletz, Carlos Seas, Uluhan Sili, Monica Slavin, Kenji Uno, Jose A. Vazquez, Thomas Weber, Barbora Weinbergerova, Deniz Yilmaz-Karapinar, Seda Yilmaz-Semerci, Jin Yu
a 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
b University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
c Department of Microbiology, Sri Ramachandra Medical College and Research Institute, SRIHER, Chennai, India
d Clinical Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain
e Department of Internal Medicine-Hematology and Oncology, Masaryk University, Brno, Czech Republic
f University Hospital Brno, Brno, Czech Republic
g Institute of Hematology and Blood Transfusion, Prague, Czech Republic
h Centre for Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology, Westmead Hospital, Sydney, NSW, Australia
i The University of Sydney, Westmead, Sydney, NSW, Australia
j Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation
k Parasitologie - Mycologie - Médecine Tropicale, CHU de Tours, France
l Centre d'Etude des Pathologies Respiratoires - Unité Inserm U1100, Université de Tours, Tours, France
m Department of Internal Medicine Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, CA, United States
n Department of Medical Microbiology and Immunology, University of California Davis Medical Center, Sacramento, CA, United States
o Center of Microbiological Research of Cesar (CIMCE), Rosario Pumarejo de López Hospital, Laura Daniela Clinic, Médicos Clinic LTDA, Valledupar, Colombia
p Division of Infectious Diseases, Departments of Medicine, Microbiology and Immunology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
q Clinical and Translational Fungal—Working Group, University of California San Diego, La Jolla, CA, United States
r Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, United States
s ECMM Excellence Center for Clinical Mycology, Section of Infectious Diseases and Tropical Medicine and Division of Pulmonology, Medical University of Graz, Graz, Austria
t Parasitology-Mycology Unit, University Hospital Center, Fort-de-France, Martinique, French West Indies
u Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
v Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, AL, United States
w Medical Service, Birmingham VA Medical Center, AL, United States
x Institute for Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
y Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
z Department of Infectious Diseases, Royal Perth Hospital, Perth, WA, Australia
aa School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
bb Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, Palestine, State of, United States
cc Department of Pediatrics, Division of Pediatric Infectious Disease, Okan University School of Medicine, Istanbul, Turkey
dd Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Italy
ee Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Research, Chandigarh, India
ff Institut des Agents Infectieux, Parasitologie Mycologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
gg Integrative Physiology of the Brain Arousal Systems, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR 5292, Faculté de Médecine, Université Claude Bernard Lyon 1, Lyon, France
hh Department of Microbiology, School of Medicine, Universidad Autonóma de Nuevo León, Nuevo León, Mexico
ii MTA-SZTE “Lendület” Mycobiome Research Group, Szeged, Hungary
jj Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
kk Department of Oncology and Hematology, Hôpitaux Universitaires de Strasbourg and Université de Strasbourg, Inserm, UMR-S1113/IRFAC, Strasbourg, France
ll epartment of Clinical Microbiology, Mycology and Antibiotic Therapy, National Research Center for Hematology, Moscow, Russia
mm Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
nn Laboratory of Antimicrobial Chemotherapy, Ion Ionescu de la Brad University, Iași, Romania
oo Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL, United States
pp Research Institute - McGill University Health Centre, Infectious Diseases and Immunity in Global Health Program, Montreal, QC, Canada
qq Wisplinghoff Laboratories, Cologne, Germany
rr Institute for Medical Microbiology, University of Cologne, Cologne, Germany
ss Institute for Virology and Microbiology, Witten/Herdecke University, Witten, Germany
tt German Centre for Infection Research (DZIF), partner site Bonn - Cologne, Cologne, Germany
uu Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
vv Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
⁎Corresponding author.
Highlights |
• | To date, 186 cases of extremely rare IFI have been documented in FungiScopeⓇ. |
• | Dematiaceae, Hypocreales, Mucorales, and Saccharomycetales caused most of the IFI. |
• | Favorable response rate was highest in Eurotiales (82.4%) and in Agaricales (80.0%). |
• | Overall mortality rate ranged from 11.8% in Eurotiales to 50.0% in Mucorales. |
• | International consortiums are core to evaluate the epidemiology of extremely rare IFI. |
Abstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Rare, Invasive fungal infections, Registry, Mold, Yeast
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© 2020
The British Infection Association. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 81 - N° 5
P. 802-815 - novembre 2020 Retour au numéro
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