Universität zu Köln

Sprute, Rosanne ORCID: 0000-0003-2457-6437, Salmanton-Garcia, Jon, Sal, Ertan ORCID: 0000-0003-2761-2675, Malaj, Xhorxha, Racil, Zdenek, de Alegria Puig, Carlos Ruiz, Falces-Romero, Iker, Barac, Aleksandra ORCID: 0000-0002-0132-2277, Desoubeaux, Guillaume, Kindo, Anupma Jyoti, Morris, Arthur J., Pelletier, Rene, Steinmann, Joerg, Thompson, George R., Cornely, Oliver A., Seidel, Danila and Stemler, Jannik (2021). Invasive infections with Purpureocillium lilacinum: clinical characteristics and outcome of 101 cases from FungiScope (R) and the literature. J. Antimicrob. Chemother., 76 (6). S. 1593 - 1604. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Objectives: To provide a basis for clinical management decisions in Purpureocillium lilacinum infection. Methods: Unpublished cases of invasive P. lilacinum infection from the FungiScope (R) registry and all cases reported in the literature were analysed. Results: We identified 101 cases with invasive P. lilacinum infection. Main predisposing factors were haematological and oncological diseases in 31 cases (30.7%), steroid treatment in 27 cases (26.7%), solid organ transplant in 26 cases (25.7%), and diabetes mellitus in 19 cases (18.8%). The most prevalent infection sites were skin (n = 37/101, 36.6%) and lungs (n = 26/101, 25.7%). Dissemination occurred in 22 cases (21.8%). Pain and fever were the most frequent symptoms (n = 40/101, 39.6% and n = 34/101, 33.7%, respectively). Diagnosis was established by culture in 98 cases (97.0%). P. lilacinum caused breakthrough infection in 10 patients (9.9%). Clinical isolates were frequently resistant to amphotericin B, whereas posaconazole and voriconazole showed good in vitro activity. Susceptibility to echinocandins varied considerably. Systemic antifungal treatment was administered in 90 patients (89.1%). Frequently employed antifungals were voriconazole in 51 (56.7%) and itraconazole in 26 patients (28.9%). Amphotericin B treatment was significantly associated with high mortality rates (n = 13/33, 39.4%, P = <0.001). Overall mortality was 21.8% (n = 22/101) and death was attributed to P. lilacinum infection in 45.5%(n = 10/22). Conclusions: P. lilacinum mainly presents as soft-tissue, pulmonary or disseminated infection in immuno-compromised patients. Owing to intrinsic resistance, accurate species identification and susceptibility testing are vital. Outcome is better in patients treated with triazoles compared with amphotericin B formulations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sprute, Rosanne UNSPECIFIED orcid.org/0000-0003-2457-6437 UNSPECIFIED Salmanton-Garcia, Jon UNSPECIFIED UNSPECIFIED UNSPECIFIED Sal, Ertan UNSPECIFIED orcid.org/0000-0003-2761-2675 UNSPECIFIED Malaj, Xhorxha UNSPECIFIED UNSPECIFIED UNSPECIFIED Racil, Zdenek UNSPECIFIED UNSPECIFIED UNSPECIFIED de Alegria Puig, Carlos Ruiz UNSPECIFIED UNSPECIFIED UNSPECIFIED Falces-Romero, Iker UNSPECIFIED UNSPECIFIED UNSPECIFIED Barac, Aleksandra UNSPECIFIED orcid.org/0000-0002-0132-2277 UNSPECIFIED Desoubeaux, Guillaume UNSPECIFIED UNSPECIFIED UNSPECIFIED Kindo, Anupma Jyoti UNSPECIFIED UNSPECIFIED UNSPECIFIED Morris, Arthur J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pelletier, Rene UNSPECIFIED UNSPECIFIED UNSPECIFIED Steinmann, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Thompson, George R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seidel, Danila UNSPECIFIED UNSPECIFIED UNSPECIFIED Stemler, Jannik UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-603038
DOI:	10.1093/jac/dkab039
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	76
Number:	6
Page Range:	S. 1593 - 1604
Date:	2021
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PAECILOMYCES-LILACINUS; FUNGAL-INFECTION; IDENTIFICATION; VORICONAZOLE; ANTIFUNGAL; THERAPY; AGENTS Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60303