Universität zu Köln

Sprute, Rosanne ORCID: 0000-0003-2457-6437, Bethe, Ullrich ORCID: 0000-0001-9979-1671, Chen, Sharon C-A and Cornely, Oliver A. ORCID: 0000-0001-9599-3137 (2022). EQUAL Trichosporon Score 2022: an ECMM score to measure QUALity of the clinical management of invasive Trichosporon infections. J. Antimicrob. Chemother., 77 (6). S. 1779 - 1785. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Background Invasive infections due to Trichosporon spp. are life-threatening opportunistic fungal infections that require complex clinical management. Guidelines assist clinicians but can be challenging to comply with. Objectives To develop a scoring tool to facilitate and quantify adherence to current guideline recommendations for invasive trichosporonosis. Methods We reviewed the current guideline for managing rare yeast infections (ECMM, ISHAM and ASM). The most important recommendations for diagnosis, treatment and follow-up were assembled and weighted according to their strength of recommendation and level of evidence. Additional items considered highly relevant for clinical management were also included. Results The resulting EQUAL Trichosporon Score 2022 comprises 18 items, with a maximum score of 39 points. For diagnostics, seven or eight items, depending on whether organ involvement is present or not, apply, resulting in a maximum of 18 or 21 points. Recommendations on diagnostics include imaging, infectious diseases expert consultation, culture, microscopy, molecular techniques, histopathology, and susceptibility testing. For treatment, six recommendations with a maximum of ten points were identified, with two additional points for organ involvement and one point for second-line treatment in uncontrolled disease. Treatment recommendations include immediate initiation, source control, pharmacological treatment, therapeutic drug monitoring, treatment duration and surgical intervention. Follow-up comprises two items with five points maximum, covering follow-up blood cultures and imaging. Conclusions The EQUAL Trichosporon Score weighs and aggregates factors recommended for optimal management of Trichosporon infections. It provides a tool for antifungal stewardship as well as for measuring guideline adherence, but remains to be correlated with patient outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sprute, Rosanne UNSPECIFIED orcid.org/0000-0003-2457-6437 UNSPECIFIED Bethe, Ullrich UNSPECIFIED orcid.org/0000-0001-9979-1671 UNSPECIFIED Chen, Sharon C-A UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED orcid.org/0000-0001-9599-3137 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-681107
DOI:	10.1093/jac/dkac085
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	77
Number:	6
Page Range:	S. 1779 - 1785
Date:	2022
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEMATOLOGICAL MALIGNANCIES; FUNGAL MICROBIOTA; MEDICAL-CENTER; WHITE PIEDRA; ASAHII; GUIDELINE; SOCIETY; UPDATE; INKIN; SPP. Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68110