Universität zu Köln

Seidel, Danila, Hassler, Angela, Salmanton-Garcia, Jon ORCID: 0000-0002-6766-8297, Koehler, Philipp ORCID: 0000-0002-7386-7495, Mellinghoff, Sibylle C., Carlesse, Fabianne, Cheng, Matthew P., Falces-Romero, Iker, Herbrecht, Raoul ORCID: 0000-0002-9381-4876, Jover Saenz, Alfredo, Klimko, Nikolai, Mares, Mihai, Lass-Floerl, Cornelia, Soler-Palacin, Pere, Wisplinghoff, Hilmar, Cornely, Oliver A., Pana, Zoi and Lehrnbecher, Thomas (2020). Invasive Scedosporium spp. and Lomentospora prolificans infections in pediatric patients: Analysis of 55 cases from FungiScope (R) and the literature. Int. J. Infect. Dis., 92. S. 114 - 123. OXFORD: ELSEVIER SCI LTD. ISSN 1878-3511

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Abstract

Objectives: Current knowledge on infections caused by Scedosporium spp. and Lomentospora prolificans in children is scarce. We therefore aim to provide an overview of risk groups, clinical manifestation and treatment strategies of these infections. Methods: Pediatric patients (age <18 years) with proven/probable Scedosporium spp. or L. prolificans infection were identified in PubMed and the FungiScope (R) registry. Data on diagnosis, treatment and outcome were collected. Results: Fifty-five children (median age 9 years [IQR: 5-14]) with invasive Scedosporium spp. (n = 33) or L. prolificans (n = 22) infection were identified between 1990 and 2019. Malignancy, trauma and near drowning were the most common risk factors. Infections were frequently disseminated. Most patients received systemic antifungal therapy, mainly voriconazole and amphotericin B, plus surgical treatment. Overall, day 42 mortality was 31%, higher for L. prolificans (50%) compared to Scedosporium spp. (18%). L. prolificans infection was associated with a shorter median survival time compared to Scedosporium spp. (6 days [IQR: 3-28] versus 61 days [IQR: 16-148]). Treatment for malignancy and severe disseminated infection were associated with particularly poor outcome (HR 8.33 [95% CI 1.35-51.40] and HR 6.12 [95% CI 1.52-24.66], respectively). Voriconazole use at any time and surgery for antifungal treatment were associated with improved clinical outcome (HR 0.33 [95% CI 0.11-0.99] and HR 0.09 [95% CI 0.02-0.40], respectively). Conclusions: Scedosporium spp. and L. prolificans infections in children are associated with high mortality despite comprehensive antifungal therapy. Voriconazole usage and surgical intervention are associated with successful outcome. (C) 2019 University Hospital of Cologne. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Seidel, Danila UNSPECIFIED UNSPECIFIED UNSPECIFIED Hassler, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED Salmanton-Garcia, Jon UNSPECIFIED orcid.org/0000-0002-6766-8297 UNSPECIFIED Koehler, Philipp UNSPECIFIED orcid.org/0000-0002-7386-7495 UNSPECIFIED Mellinghoff, Sibylle C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Carlesse, Fabianne UNSPECIFIED UNSPECIFIED UNSPECIFIED Cheng, Matthew P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Falces-Romero, Iker UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbrecht, Raoul UNSPECIFIED orcid.org/0000-0002-9381-4876 UNSPECIFIED Jover Saenz, Alfredo UNSPECIFIED UNSPECIFIED UNSPECIFIED Klimko, Nikolai UNSPECIFIED UNSPECIFIED UNSPECIFIED Mares, Mihai UNSPECIFIED UNSPECIFIED UNSPECIFIED Lass-Floerl, Cornelia UNSPECIFIED UNSPECIFIED UNSPECIFIED Soler-Palacin, Pere UNSPECIFIED UNSPECIFIED UNSPECIFIED Wisplinghoff, Hilmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pana, Zoi UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehrnbecher, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-342772
DOI:	10.1016/j.ijid.2019.12.017
Journal or Publication Title:	Int. J. Infect. Dis.
Volume:	92
Page Range:	S. 114 - 123
Date:	2020
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1878-3511
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC GRANULOMATOUS-DISEASE; LIPOSOMAL AMPHOTERICIN-B; PSEUDALLESCHERIA-BOYDII; FUNGAL-INFECTIONS; BRAIN-ABSCESS; APIOSPERMUM; CHILD; VORICONAZOLE; OSTEOMYELITIS; THERAPY Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34277