Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry

Livio Pagano, Jeffrey D Jenks, Danila Seidel, Oliver A Cornely, Sharon Chen, Sebastiaan van Hal, Carol Kauffman, Marisa H Miceli, Melina Heinemann, Martin Christner, Alfredo Jover Sáenz, Alexander Burchardt, Björn Kemmerling, Raoul Herbrecht, Joerg Steinmann, Shmuel Shoham, Sandra Gräber, Dries Deeren, Monica A Slavin, Martin Hoenigl

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

OBJECTIVES: Invasive fungal infections caused by Lomentospora prolificans are associated with very high mortality rates and can be challenging to treat given pan-drug resistance to available antifungal agents. The objective of this study was to describe the clinical presentation and outcomes in a cohort of patients with invasive L prolificans infections. METHODS: We performed a retrospective review of medical records of patients with invasive L prolificans infection in the FungiScope® registry of rare invasive fungal infections. Patients diagnosed between 01 January 2008 and 09 September 2019 were included in for analysis. RESULTS: The analysis included 41 patients with invasive L prolificans infection from eight different countries. Haematological/oncological malignancies were the most frequent underlying disease (66%), disseminated infection was frequent (61%), and the lung was the most commonly involved organ (44%). Most infections (59%) were breakthrough infections. Progression/deterioration/treatment failure was observed in 23/40 (58%) of patients receiving antifungal therapy. In total, 21/41 (51%) patients, and 77% of patients with underlying haematological/oncological malignancy, had a fatal outcome attributed to invasive fungal infection. Combination antifungal therapy was frequent (24/40) and associated with improved survival. In particular, treatment regimens including terbinafine were significantly associated with higher treatment success at final assessment (P = .012), with a positive trend observed for treatment regimens that included voriconazole (P = .054). CONCLUSIONS: Lomentospora prolificans infections were associated with mortality rates of 77% and above in patients with underlying haematological/oncological malignancies and those with disseminated infections. While combination therapy is the preferred option for now, the hope lies with novel antifungals currently under development.
Lingua originaleEnglish
pagine (da-a)437-442
Numero di pagine6
RivistaMycoses
Volume63
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Lomentospora prolificans
  • clinical presentation
  • fungal infections
  • outcomes
  • treatment

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