Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry
Summary 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...
Gespeichert in:
| Veröffentlicht in: | Mycoses 2020-05, Vol.63 (5), p.437-442 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 442 |
|---|---|
| container_issue | 5 |
| container_start_page | 437 |
| container_title | Mycoses |
| container_volume | 63 |
| creator | Jenks, Jeffrey D. Seidel, Danila Cornely, Oliver A. Chen, Sharon Hal, Sebastiaan Kauffman, Carol Miceli, Marisa H. Heinemann, Melina Christner, Martin Jover Sáenz, Alfredo Burchardt, Alexander Kemmerling, Björn Herbrecht, Raoul Steinmann, Joerg Shoham, Shmuel Gräber, Sandra Pagano, Livio Deeren, Dries Slavin, Monica A. Hoenigl, Martin |
| description | Summary
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. |
| doi_str_mv | 10.1111/myc.13067 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2390642142</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2390642142</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3887-9f7c1703ec67d7ecae67a79c5ed163d1b450888b3e2d3148f2a0cecc13e0df0b3</originalsourceid><addsrcrecordid>eNp10UFu1DAUBmCrArVDYdELVJbYlEXaZzsTJ91VoxaQBrEAFqwiz8tL6yqxg520yg04DYfgZHhmCotKeGPJ-t5vWz9jJwLORVoX_YznQkGhD9hC5KrKYAn6BVtApVSmc9BH7FWM9wBCV7I4ZEdKQgkVyAX7ueqss2g6jncmGBwp2DhajNy4hvtpRN9T5L7l1j2YaB-Ir9OJG30cfDB8CL6zbQpwMYmWcLTexUt-5Uw3R7ubHMxo08QW8PGO-M3kbu0X9AP9_sUD3aYLw_yavWxNF-nN037Mvt1cf119yNaf339cXa0zVGWps6rVKDQowkI3mtBQoY2ucEmNKFQjNvkSyrLcKJKNEnnZSgNIiEIRNC1s1DE72-eml_-YKI51byNS1xlHfoq1VBUUuRS5TPTtM3rvp5A-tlNSy1LrrXq3Vxh8jIHaegi2N2GuBdTbeupUT72rJ9nTp8Rp01PzT_7tI4GLPXi0Hc3_T6o_fV_tI_8AGvSdNQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2392728772</pqid></control><display><type>article</type><title>Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Jenks, Jeffrey D. ; Seidel, Danila ; Cornely, Oliver A. ; Chen, Sharon ; Hal, Sebastiaan ; Kauffman, Carol ; Miceli, Marisa H. ; Heinemann, Melina ; Christner, Martin ; Jover Sáenz, Alfredo ; Burchardt, Alexander ; Kemmerling, Björn ; Herbrecht, Raoul ; Steinmann, Joerg ; Shoham, Shmuel ; Gräber, Sandra ; Pagano, Livio ; Deeren, Dries ; Slavin, Monica A. ; Hoenigl, Martin</creator><creatorcontrib>Jenks, Jeffrey D. ; Seidel, Danila ; Cornely, Oliver A. ; Chen, Sharon ; Hal, Sebastiaan ; Kauffman, Carol ; Miceli, Marisa H. ; Heinemann, Melina ; Christner, Martin ; Jover Sáenz, Alfredo ; Burchardt, Alexander ; Kemmerling, Björn ; Herbrecht, Raoul ; Steinmann, Joerg ; Shoham, Shmuel ; Gräber, Sandra ; Pagano, Livio ; Deeren, Dries ; Slavin, Monica A. ; Hoenigl, Martin</creatorcontrib><description>Summary
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.</description><identifier>ISSN: 0933-7407</identifier><identifier>EISSN: 1439-0507</identifier><identifier>DOI: 10.1111/myc.13067</identifier><identifier>PMID: 32080902</identifier><language>eng</language><publisher>Germany: Wiley Subscription Services, Inc</publisher><subject>Antifungal agents ; clinical presentation ; Disseminated infection ; Drug resistance ; Fungal infections ; Hematology ; Lomentospora prolificans ; Malignancy ; Medical records ; Mortality ; outcomes ; Patients ; Terbinafine ; treatment ; Voriconazole</subject><ispartof>Mycoses, 2020-05, Vol.63 (5), p.437-442</ispartof><rights>2020 Blackwell Verlag GmbH</rights><rights>2020 Blackwell Verlag GmbH.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3887-9f7c1703ec67d7ecae67a79c5ed163d1b450888b3e2d3148f2a0cecc13e0df0b3</citedby><cites>FETCH-LOGICAL-c3887-9f7c1703ec67d7ecae67a79c5ed163d1b450888b3e2d3148f2a0cecc13e0df0b3</cites><orcidid>0000-0002-1653-2824 ; 0000-0001-9599-3137 ; 0000-0001-6632-9587 ; 0000-0002-3175-0512</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fmyc.13067$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fmyc.13067$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32080902$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jenks, Jeffrey D.</creatorcontrib><creatorcontrib>Seidel, Danila</creatorcontrib><creatorcontrib>Cornely, Oliver A.</creatorcontrib><creatorcontrib>Chen, Sharon</creatorcontrib><creatorcontrib>Hal, Sebastiaan</creatorcontrib><creatorcontrib>Kauffman, Carol</creatorcontrib><creatorcontrib>Miceli, Marisa H.</creatorcontrib><creatorcontrib>Heinemann, Melina</creatorcontrib><creatorcontrib>Christner, Martin</creatorcontrib><creatorcontrib>Jover Sáenz, Alfredo</creatorcontrib><creatorcontrib>Burchardt, Alexander</creatorcontrib><creatorcontrib>Kemmerling, Björn</creatorcontrib><creatorcontrib>Herbrecht, Raoul</creatorcontrib><creatorcontrib>Steinmann, Joerg</creatorcontrib><creatorcontrib>Shoham, Shmuel</creatorcontrib><creatorcontrib>Gräber, Sandra</creatorcontrib><creatorcontrib>Pagano, Livio</creatorcontrib><creatorcontrib>Deeren, Dries</creatorcontrib><creatorcontrib>Slavin, Monica A.</creatorcontrib><creatorcontrib>Hoenigl, Martin</creatorcontrib><title>Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry</title><title>Mycoses</title><addtitle>Mycoses</addtitle><description>Summary
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.</description><subject>Antifungal agents</subject><subject>clinical presentation</subject><subject>Disseminated infection</subject><subject>Drug resistance</subject><subject>Fungal infections</subject><subject>Hematology</subject><subject>Lomentospora prolificans</subject><subject>Malignancy</subject><subject>Medical records</subject><subject>Mortality</subject><subject>outcomes</subject><subject>Patients</subject><subject>Terbinafine</subject><subject>treatment</subject><subject>Voriconazole</subject><issn>0933-7407</issn><issn>1439-0507</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp10UFu1DAUBmCrArVDYdELVJbYlEXaZzsTJ91VoxaQBrEAFqwiz8tL6yqxg520yg04DYfgZHhmCotKeGPJ-t5vWz9jJwLORVoX_YznQkGhD9hC5KrKYAn6BVtApVSmc9BH7FWM9wBCV7I4ZEdKQgkVyAX7ueqss2g6jncmGBwp2DhajNy4hvtpRN9T5L7l1j2YaB-Ir9OJG30cfDB8CL6zbQpwMYmWcLTexUt-5Uw3R7ubHMxo08QW8PGO-M3kbu0X9AP9_sUD3aYLw_yavWxNF-nN037Mvt1cf119yNaf339cXa0zVGWps6rVKDQowkI3mtBQoY2ucEmNKFQjNvkSyrLcKJKNEnnZSgNIiEIRNC1s1DE72-eml_-YKI51byNS1xlHfoq1VBUUuRS5TPTtM3rvp5A-tlNSy1LrrXq3Vxh8jIHaegi2N2GuBdTbeupUT72rJ9nTp8Rp01PzT_7tI4GLPXi0Hc3_T6o_fV_tI_8AGvSdNQ</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Jenks, Jeffrey D.</creator><creator>Seidel, Danila</creator><creator>Cornely, Oliver A.</creator><creator>Chen, Sharon</creator><creator>Hal, Sebastiaan</creator><creator>Kauffman, Carol</creator><creator>Miceli, Marisa H.</creator><creator>Heinemann, Melina</creator><creator>Christner, Martin</creator><creator>Jover Sáenz, Alfredo</creator><creator>Burchardt, Alexander</creator><creator>Kemmerling, Björn</creator><creator>Herbrecht, Raoul</creator><creator>Steinmann, Joerg</creator><creator>Shoham, Shmuel</creator><creator>Gräber, Sandra</creator><creator>Pagano, Livio</creator><creator>Deeren, Dries</creator><creator>Slavin, Monica A.</creator><creator>Hoenigl, Martin</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1653-2824</orcidid><orcidid>https://orcid.org/0000-0001-9599-3137</orcidid><orcidid>https://orcid.org/0000-0001-6632-9587</orcidid><orcidid>https://orcid.org/0000-0002-3175-0512</orcidid></search><sort><creationdate>202005</creationdate><title>Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry</title><author>Jenks, Jeffrey D. ; Seidel, Danila ; Cornely, Oliver A. ; Chen, Sharon ; Hal, Sebastiaan ; Kauffman, Carol ; Miceli, Marisa H. ; Heinemann, Melina ; Christner, Martin ; Jover Sáenz, Alfredo ; Burchardt, Alexander ; Kemmerling, Björn ; Herbrecht, Raoul ; Steinmann, Joerg ; Shoham, Shmuel ; Gräber, Sandra ; Pagano, Livio ; Deeren, Dries ; Slavin, Monica A. ; Hoenigl, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3887-9f7c1703ec67d7ecae67a79c5ed163d1b450888b3e2d3148f2a0cecc13e0df0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Antifungal agents</topic><topic>clinical presentation</topic><topic>Disseminated infection</topic><topic>Drug resistance</topic><topic>Fungal infections</topic><topic>Hematology</topic><topic>Lomentospora prolificans</topic><topic>Malignancy</topic><topic>Medical records</topic><topic>Mortality</topic><topic>outcomes</topic><topic>Patients</topic><topic>Terbinafine</topic><topic>treatment</topic><topic>Voriconazole</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jenks, Jeffrey D.</creatorcontrib><creatorcontrib>Seidel, Danila</creatorcontrib><creatorcontrib>Cornely, Oliver A.</creatorcontrib><creatorcontrib>Chen, Sharon</creatorcontrib><creatorcontrib>Hal, Sebastiaan</creatorcontrib><creatorcontrib>Kauffman, Carol</creatorcontrib><creatorcontrib>Miceli, Marisa H.</creatorcontrib><creatorcontrib>Heinemann, Melina</creatorcontrib><creatorcontrib>Christner, Martin</creatorcontrib><creatorcontrib>Jover Sáenz, Alfredo</creatorcontrib><creatorcontrib>Burchardt, Alexander</creatorcontrib><creatorcontrib>Kemmerling, Björn</creatorcontrib><creatorcontrib>Herbrecht, Raoul</creatorcontrib><creatorcontrib>Steinmann, Joerg</creatorcontrib><creatorcontrib>Shoham, Shmuel</creatorcontrib><creatorcontrib>Gräber, Sandra</creatorcontrib><creatorcontrib>Pagano, Livio</creatorcontrib><creatorcontrib>Deeren, Dries</creatorcontrib><creatorcontrib>Slavin, Monica A.</creatorcontrib><creatorcontrib>Hoenigl, Martin</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Mycoses</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jenks, Jeffrey D.</au><au>Seidel, Danila</au><au>Cornely, Oliver A.</au><au>Chen, Sharon</au><au>Hal, Sebastiaan</au><au>Kauffman, Carol</au><au>Miceli, Marisa H.</au><au>Heinemann, Melina</au><au>Christner, Martin</au><au>Jover Sáenz, Alfredo</au><au>Burchardt, Alexander</au><au>Kemmerling, Björn</au><au>Herbrecht, Raoul</au><au>Steinmann, Joerg</au><au>Shoham, Shmuel</au><au>Gräber, Sandra</au><au>Pagano, Livio</au><au>Deeren, Dries</au><au>Slavin, Monica A.</au><au>Hoenigl, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry</atitle><jtitle>Mycoses</jtitle><addtitle>Mycoses</addtitle><date>2020-05</date><risdate>2020</risdate><volume>63</volume><issue>5</issue><spage>437</spage><epage>442</epage><pages>437-442</pages><issn>0933-7407</issn><eissn>1439-0507</eissn><abstract>Summary
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.</abstract><cop>Germany</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32080902</pmid><doi>10.1111/myc.13067</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-1653-2824</orcidid><orcidid>https://orcid.org/0000-0001-9599-3137</orcidid><orcidid>https://orcid.org/0000-0001-6632-9587</orcidid><orcidid>https://orcid.org/0000-0002-3175-0512</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0933-7407 |
| ispartof | Mycoses, 2020-05, Vol.63 (5), p.437-442 |
| issn | 0933-7407 1439-0507 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2390642142 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Antifungal agents clinical presentation Disseminated infection Drug resistance Fungal infections Hematology Lomentospora prolificans Malignancy Medical records Mortality outcomes Patients Terbinafine treatment Voriconazole |
| title | Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope® registry |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T15%3A00%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20characteristics%20and%20outcomes%20of%20invasive%20Lomentospora%20prolificans%20infections:%20Analysis%20of%20patients%20in%20the%20FungiScope%C2%AE%20registry&rft.jtitle=Mycoses&rft.au=Jenks,%20Jeffrey%20D.&rft.date=2020-05&rft.volume=63&rft.issue=5&rft.spage=437&rft.epage=442&rft.pages=437-442&rft.issn=0933-7407&rft.eissn=1439-0507&rft_id=info:doi/10.1111/myc.13067&rft_dat=%3Cproquest_cross%3E2390642142%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2392728772&rft_id=info:pmid/32080902&rfr_iscdi=true |