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Updated: Jun 8, 2026
Isolation of Culturable Yeasts and Molds from Soils to Investigate Fungal Population Structure
Published on: May 27, 2022
Epidemiology and Prognostic Factors Associated With Mold-Positive Blood Cultures: 10-Year Data From a French
Thiziri Tala-Ighil1, Dea Garcia-Hermoso2, Frédéric Dalle3
1Infectious Disease Department, Assistance-Publique Hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants Malades.
Background:
While invasive fusariosis and lomentosporiosis are known to be associated with fungemia, overall data on mold-related fungemia are limited, hampering early management. This study aimed to describe the epidemiology of mold-positive blood cultures.
Methods:
Epidemiological and clinical data on mold-positive blood cultures from 2012 to 2022 were obtained from the RESSIF database. Pseudofungemia was excluded using modified Duthie and Denning criteria. Univariable and multivariable Firth logistical regression was used to study factors associated with 90-day mortality.
Results:
Fusarium spp accounted for 67.5% of the 80 events, involving predominantly Fusarium fujikuroi spp complex (FFSC), Neocosmospora spp, and Fusarium oxysporum spp complex (FOSC). Lomentospora prolificans was the second most frequent (10%), followed by Trichoderma spp, Aspergillus spp, and Mucorales (5% each).Most patients had a history of hematological malignancy (HM) (70%). Forty-three percent had undergone allogeneic hematopoietic stem cell transplantation. Cutaneous and pulmonary lesions were common (43% each). Median time to blood culture positivity was 72 hours.HM and neutropenia were commonly reported in patients with FFSC, Neocosmospora spp, and L. prolificans fungemia. Pulmonary lesions were frequent in cases of L. prolificans fungemia. Patients with gastrointestinal conditions were frequently diagnosed with FOSC molds. HM (75%), particularly acute myeloblastic leukemia, was frequent in patients with Aspergillus spp fungemia. All patients with Trichoderma spp fungemia were exposed to corticosteroids.Day 90 mortality was 53%. Independent predictive factors of day 90 mortality included L. prolificans (odds ratio [OR], 33.3), Aspergillus spp fungemia (OR, 14.2), and corticosteroid exposure (OR, 7.85).
Conclusions:
Underlying conditions and clinical presentation vary between genera and could be considered to guide early management.
Insights
Mold-related fungemia, particularly Fusarium, Lomentospora, and Aspergillus, significantly impacts patients with hematological malignancies. Early identification of specific mold genera and risk factors like corticosteroid use is crucial for managing 90-day mortality in mold fungemia.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hematology
Background:
- Limited data exists on mold-related fungemia, hindering timely clinical management.
- Invasive fusariosis and lomentosporiosis are known causes, but a broader epidemiological overview is needed.
Purpose of the Study:
- To describe the epidemiology of mold-positive blood cultures.
- To identify factors associated with mortality in mold fungemia.
Main Methods:
- Retrospective analysis of mold-positive blood cultures from 2012-2022 using the RESSIF database.
- Exclusion of pseudofungemia using modified Duthie and Denning criteria.
- Application of Firth logistical regression to determine predictors of 90-day mortality.
Main Results:
- Fusarium spp. (67.5%) were the most common cause, followed by Lomentospora prolificans (10%).
- Hematological malignancy (70%) was a frequent underlying condition, with specific associations for different mold genera.
- The 90-day mortality rate was 53%, with L. prolificans, Aspergillus spp. fungemia, and corticosteroid exposure identified as independent predictors.
Conclusions:
- Underlying conditions and clinical presentations differ across mold genera.
- Recognizing these variations can aid in guiding early management strategies for mold fungemia.
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