학술논문
Invasive infections with Purpureocillium lilacinum: clinical characteristics and outcome of 101 cases from FungiScope® and the literature
Document Type
article
Author
Sprute, Rosanne; Salmanton-García, Jon; Sal, Ertan; Malaj, Xhorxha; Ráčil, Zdeněk; de Alegría Puig, Carlos Ruiz; Falces-Romero, Iker; Barać, Aleksandra; Desoubeaux, Guillaume; Kindo, Anupma Jyoti; Morris, Arthur J; Pelletier, René; Steinmann, Joerg; Thompson, George R; Cornely, Oliver A; Seidel, Danila; Stemler, Jannik; Group, the FungiScope ECMM ISHAM Working
Source
Journal of Antimicrobial Chemotherapy. 76(6)
Subject
Language
Abstract
ObjectivesTo provide a basis for clinical management decisions in Purpureocillium lilacinum infection.MethodsUnpublished cases of invasive P. lilacinum infection from the FungiScope® registry and all cases reported in the literature were analysed.ResultsWe 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 =