Universität zu Köln

Stemler, Jannik ORCID: 0000-0001-9152-2469, Salmanton-Garcia, Jon ORCID: 0000-0002-6766-8297, Seidel, Danila, Alexander, Barbara D., Bertz, Hartmut, Hoenigl, Martin ORCID: 0000-0002-1653-2824, Herbrecht, Raoul ORCID: 0000-0002-9381-4876, Meintker, Lisa, Meissner, Arne ORCID: 0000-0002-8506-1624, Mellinghoff, Sibylle C., Sal, Ertan, Zarrouk, Marouan, Koehler, Philipp ORCID: 0000-0002-7386-7495 and Cornely, Oliver A. (2020). Risk factors and mortality in invasive Rasamsonia spp. infection: Analysis of cases in the FungiScope registry and from the literature. Mycoses, 63 (3). S. 265 - 275. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Background The new Rasamsonia spp. complex can develop invasive infection in immunosuppression or chronic pulmonary disease. It has potential to be misidentified as other genera due to morphological similarities. Nowadays, there is a gap of knowledge on this fungi. Objectives To provide knowledge base of risk factors and therapeutic decisions in invasive Rasamsonia spp. complex infection. Patients/Methods Cases of invasive infection due to Rasamsonia spp. (formerly Geosmithia/Penicillium spp.) from FungiScope registry and all reported cases from a literature were included. Results We identified 23 invasive infections due to Rasamsonia spp., six (26.1%) in the FungiScope registry. Main risk factors were chronic granulomatous disease (n = 12, 52.2%), immunosuppressive treatment (n = 10, 43.5%), haematopoietic stem cell transplantation (n = 7, 30.4%), graft-versus-host disease and major surgery (n = 4, 17.4%, each). Predominantly affected organs were the lungs (n = 21, 91.3%), disease disseminated in seven cases (30.4%). Fungal misidentification occurred in 47.8% (n = 11), and sequencing was used in 69.6% of the patients (n = 16) to diagnose. Breakthrough infection occurred in 13 patients (56.5%). All patients received antifungal treatment, mostly posaconazole (n = 11), caspofungin (n = 10) or voriconazole (n = 9). Combination therapy was administered in 13 patients (56.5%). Susceptibility testing showed high minimum inhibitory concentrations for azoles and amphotericin B, but not for echinocandins. No preferable treatment influencing favourable outcome was identified. Overall mortality was 39% (n = 9). Conclusion Rasamsonia spp. are emerging fungi causing life-threatening infections, especially in immunocompromised and critically ill patients. Mortality is high. Treatment is challenging and clinicians dealing with this patient population should become aware of this infection constituting a medical emergency.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stemler, Jannik UNSPECIFIED orcid.org/0000-0001-9152-2469 UNSPECIFIED Salmanton-Garcia, Jon UNSPECIFIED orcid.org/0000-0002-6766-8297 UNSPECIFIED Seidel, Danila UNSPECIFIED UNSPECIFIED UNSPECIFIED Alexander, Barbara D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bertz, Hartmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoenigl, Martin UNSPECIFIED orcid.org/0000-0002-1653-2824 UNSPECIFIED Herbrecht, Raoul UNSPECIFIED orcid.org/0000-0002-9381-4876 UNSPECIFIED Meintker, Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Meissner, Arne UNSPECIFIED orcid.org/0000-0002-8506-1624 UNSPECIFIED Mellinghoff, Sibylle C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sal, Ertan UNSPECIFIED UNSPECIFIED UNSPECIFIED Zarrouk, Marouan UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehler, Philipp UNSPECIFIED orcid.org/0000-0002-7386-7495 UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-124663
DOI:	10.1111/myc.13039
Journal or Publication Title:	Mycoses
Volume:	63
Number:	3
Page Range:	S. 265 - 275
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GEOSMITHIA-ARGILLACEA INFECTION; FUNGAL-INFECTIONS; PAECILOMYCES-VARIOTII; MOLD INFECTIONS; EPIDEMIOLOGY; DEFINITIONS; PENICILLIUM; PNEUMONIA; TAXONOMY; PATIENT Multiple languages Dermatology; Mycology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12466