Invasive infections due to Saprochaete and Geotrichum species: Report of 23 cases from the FungiScope Registry |
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| Authors: | Luisa Durán Graeff Danila Seidel Maria J. G. T. Vehreschild Axel Hamprecht Anupma Kindo Zdenek Racil Judit Demeter Sybren De Hoog Ute Aurbach Maren Ziegler Hilmar Wisplinghoff Oliver A. Cornely FungiScope Group |
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| Affiliation: | 1. Division of Infectious Diseases, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany;2. Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany;3. Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Chennai, India;4. Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic;5. First Department of Internal Medicine, Division of Hematology, Semmelweis University, Budapest, Hungary;6. CBS‐KNAW, Fungal Biodiversity Centre, Utrecht, Netherlands;7. Laboratory Dr. Wisplinghoff, Cologne, Germany;8. Institute for Virology and Medical Microbiology, University Witten/Herdecke, Witten, Germany;9. Cologne Excellence Cluster on Cellular Stress Responses in Aging‐Associated Diseases (CECAD), Cologne, Germany;10. German Centre for Infection Research, Partner Site Bonn‐Cologne, Cologne, Germany;11. Clinical Trials Centre Cologne, ZKS K?ln, Cologne, Germany |
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| Abstract: | ![]()
Saprochaete and Geotrichum spp. are rare emerging fungi causing invasive fungal diseases in immunosuppressed patients and scarce evidence is available for treatment decisions. Among 505 cases of rare IFD from the FungiScope? registry, we identified 23 cases of invasive infections caused by these fungi reported from 10 countries over a 12‐year period. All cases were adults and previous chemotherapy with associated neutropenia was the most common co‐morbidity. Fungaemia was confirmed in 14 (61%) cases and deep organ involvement included lungs, liver, spleen, central nervous system and kidneys. Fungi were S. capitata (n=14), S. clavata (n=5), G. candidum (n=2) and Geotrichum spp. (n=2). Susceptibility was tested in 16 (70%) isolates. All S. capitata and S. clavata isolates with the exception of one S. capitata (MIC 4 mg/L) isolate had MICs>32 mg/L for caspofungin. For micafungin and anidulafungin, MICs varied between 0.25 and >32 mg/L. One case was diagnosed postmortem, 22 patients received targeted treatment, with voriconazole as the most frequent first line drug. Overall mortality was 65% (n=15). Initial echinocandin treatment was associated with worse outcome at day 30 when compared to treatment with other antifungals (amphotericin B ± flucytosine, voriconazole, fluconazole and itraconazole) (P=.036). Echinocandins are not an option for these infections. |
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| Keywords: |
Geotrichum
invasive fungal diseases
Saprochaete
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