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Fusarium, Scedosporium and Other Rare Mold Invasive Infections: Over Twenty-Five-Year Experience of a European

Marie-Pierre Ledoux1, Elise Dicop2, Marcela Sabou3,4

  • 1Department of Hematology, Institut de Cancérologie de Strasbourg, 67033 Strasbourg, France.

Journal of Fungi (Basel, Switzerland)
|April 26, 2024
PubMed

Insights

Invasive mold infections (IMD) are a growing concern, with Fusarium and Scedosporium species causing higher mortality. Understanding these less-known fungal infections is crucial for improving outcomes in at-risk patients.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Invasive mold infections (IMD) are increasing due to a rise in immunocompromised patient populations.
  • Hyalohyphomycoses and phaeohyphomycoses are less understood compared to invasive aspergillosis and mucormycosis.
  • Patients at risk include stem cell transplant recipients, those with hematological malignancies, solid organ transplant recipients, and ICU patients.

Purpose of the Study:

  • To retrospectively analyze the clinical, biological, microbiological, and evolutive features of 92 invasive mold infections.
  • To identify common and emerging mold pathogens causing IMD.
  • To assess mortality rates and influencing factors in IMD patients.

Main Methods:

  • Retrospective analysis of 92 cases of invasive mold infections over 25 years.
  • Microbiological identification of causative mold species.
  • Clinical data collection including patient demographics, risk factors, and outcomes.
  • Statistical analysis of mortality rates and associated factors.

Main Results:

  • A quarter of IMD cases involved multiple fungal pathogens.
  • Fusarium spp. (36.2%) and Scedosporium spp. (14.5%) were the most common single-agent pathogens.
  • Mortality at day 84 was significantly higher for Fusarium spp., Scedosporium spp., or multiple-pathogen IMD (51.7%) compared to other pathogens (17.6%).
  • Mortality was also higher in hematology and allogeneic hematopoietic stem cell transplant (alloHSCT) patients.

Conclusions:

  • Fusarium and Scedosporium species, along with polymicrobial infections, are associated with increased mortality in IMD.
  • Hematological malignancy and alloHSCT patients face a higher risk of mortality from IMD.
  • Enhanced awareness, understanding, and treatment strategies are needed to improve prognoses for invasive mold infections.
Keywords:
AlternariaFusariumHyalohyphomycetesPhaeohyphomycetesScedosporiumfungal infectionimmunocompromised patientsinvasive mold disease

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