Emmanouil Glampedakis1, Sophie Cassaing2, Arnaud Fekkar3, Eric Dannaoui4, Marie-Elisabeth Bougnoux5, Stéphane Bretagne6, Dionysios Neofytos7, Peter W Schreiber8, Christophe Hennequin9, Florent Morio10, Olga Shadrivova11, Felix Bongomin12, Mario Fernández-Ruiz13, Anne Pauline Bellanger14, Sevtap Arikan-Akdagli15, Veronique Erard16, Maria Aigner17, Michela Paolucci18, Nina Khanna19, Eléna Charpentier2, Christine Bonnal20, Sophie Brun21, Frederic Gabriel22, Arnaud Riat23, Reinhard Zbinden8, Patrice Le Pape10, Nikolai Klimko11, Russel E Lewis24, Malcolm Richardson12, Ahmet Cagkan İnkaya25, Alix T Coste26, Pierre-Yves Bochud1, Frederic Lamoth1,26. 1. Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. 2. Department of Parasitology and Mycology, Toulouse University Hospital, Paul Sabatier University, Toulouse, France. 3. Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France. 4. Paris-Descartes University, Faculty of Medicine, AP-HP, European Georges Pompidou Hospital, Parasitology-Mycology Unit, Paris, France. 5. Department of Microbiology, Necker-Enfants malades Hospital, AP-HP, Paris Descartes University, Paris, France. 6. Université de Paris, Parasitology-Mycology Laboratory, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France. 7. Infectious Disease Service, Department of Internal Medicine, Geneva University Hospital, Geneva, Switzerland. 8. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland. 9. Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Paris, France. 10. Parasitology and Medical Mycology Laboratory, Nantes University Hospital, Nantes, France. 11. Mechnikov North-Western State Medical University, St Petersburg, Russian Federation, St Petersburg, Russia. 12. Mycology Reference Centre-Manchester, ECMM Center of Excellence in Clinical and Laboratory Mycology and Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom. 13. Unit of Infectious Diseases, Hospital Universitario "12 de Octubre," Instituto de Investigación Hospital "12 de Octubre" (imas12), Madrid, Spain. 14. Parasitology-Mycology Department, University Hospital, Besancon, France. 15. Mycology Laboratory, Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey. 16. Clinique de Médecine et Spécialités, Infectiologie, HFR-Fribourg, Fribourg, Switzerland. 17. Institute for Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria. 18. Unit of Clinical Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy. 19. Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland. 20. Parasitology Mycology Laboratory, Bichat Claude Bernard Universitary Hospital, Paris, France. 21. Parasitology-Mycology Department, Avicenne University Hospital, AP-HP, Bobigny, France. 22. CHU Bordeaux, Department of Parasitology and Mycology, Bordeaux, France. 23. Service of Laboratory Medicine, Department of Diagnostic, Geneva University Hospitals and Geneva University, Geneva, Switzerland. 24. Infectious Diseases Unit, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. 25. Department of Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey. 26. Institute of Microbiology, Department of Laboratories, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Abstract
BACKGROUND: Aspergillus spp. of section Usti (A. ustus) represent a rare cause of invasive aspergillosis (IA). This multicenter study describes the epidemiology and outcome of A. ustus infections. METHODS: Patients with A. ustus isolated from any clinical specimen were retrospectively identified in 22 hospitals from 8 countries. When available, isolates were sent for species identification (BenA/CaM sequencing) and antifungal susceptibility testing. Additional cases were identified by review of the literature. Cases were classified as proven/probable IA or no infection, according to standard international criteria. RESULTS: Clinical report forms were obtained for 90 patients, of whom 27 had proven/probable IA. An additional 45 cases were identified from literature review for a total of 72 cases of proven/probable IA. Hematopoietic cell and solid-organ transplant recipients accounted for 47% and 33% cases, respectively. Only 8% patients were neutropenic at time of diagnosis. Ongoing antimold prophylaxis was present in 47% of cases. Pulmonary IA represented 67% of cases. Primary or secondary extrapulmonary sites of infection were observed in 46% of cases, with skin being affected in 28% of cases. Multiple antifungal drugs were used (consecutively or in combination) in 67% of cases. The 24-week mortality rate was 58%. A. calidoustus was the most frequent causal agent. Minimal inhibitory concentrations encompassing 90% isolates (MIC90) were 1, 8, >16, and 4 µg/mL for amphotericin B, voriconazole, posaconazole, and isavuconazole, respectively. CONCLUSIONS: Aspergillus ustus IA mainly occurred in nonneutropenic transplant patients and was frequently associated with extrapulmonary sites of infection. Mortality rate was high and optimal antifungal therapy remains to be defined.
BACKGROUND:Aspergillus spp. of section Usti (A. ustus) represent a rare cause of invasive aspergillosis (IA). This multicenter study describes the epidemiology and outcome of A. ustus infections. METHODS:Patients with A. ustus isolated from any clinical specimen were retrospectively identified in 22 hospitals from 8 countries. When available, isolates were sent for species identification (BenA/CaM sequencing) and antifungal susceptibility testing. Additional cases were identified by review of the literature. Cases were classified as proven/probable IA or no infection, according to standard international criteria. RESULTS: Clinical report forms were obtained for 90 patients, of whom 27 had proven/probable IA. An additional 45 cases were identified from literature review for a total of 72 cases of proven/probable IA. Hematopoietic cell and solid-organ transplant recipients accounted for 47% and 33% cases, respectively. Only 8% patients were neutropenic at time of diagnosis. Ongoing antimold prophylaxis was present in 47% of cases. Pulmonary IA represented 67% of cases. Primary or secondary extrapulmonary sites of infection were observed in 46% of cases, with skin being affected in 28% of cases. Multiple antifungal drugs were used (consecutively or in combination) in 67% of cases. The 24-week mortality rate was 58%. A. calidoustus was the most frequent causal agent. Minimal inhibitory concentrations encompassing 90% isolates (MIC90) were 1, 8, >16, and 4 µg/mL for amphotericin B, voriconazole, posaconazole, and isavuconazole, respectively. CONCLUSIONS:Aspergillus ustusIA mainly occurred in nonneutropenic transplant patients and was frequently associated with extrapulmonary sites of infection. Mortality rate was high and optimal antifungal therapy remains to be defined.
Authors: A Arastehfar; A Carvalho; J Houbraken; L Lombardi; R Garcia-Rubio; J D Jenks; O Rivero-Menendez; R Aljohani; I D Jacobsen; J Berman; N Osherov; M T Hedayati; M Ilkit; D James-Armstrong; T Gabaldón; J Meletiadis; M Kostrzewa; W Pan; C Lass-Flörl; D S Perlin; M Hoenigl Journal: Stud Mycol Date: 2021-05-10 Impact factor: 16.097
Authors: James S Lewis; Nathan P Wiederhold; Morgan Hakki; George R Thompson Journal: Antimicrob Agents Chemother Date: 2022-08-15 Impact factor: 5.938
Authors: Jose F Camargo; Ra'ed Jabr; Anthony D Anderson; Lazaros Lekakis; Meilin Diaz-Paez; Laurence M Briski; Mohammed Raja; Michele I Morris; Krishna V Komanduri; Denise Pereira Journal: Antimicrob Agents Chemother Date: 2021-12-20 Impact factor: 5.938