Risk factors and mortality in invasive Rasamsonia spp. infection: Analysis of cases in the FungiScope® registry and from the literature

Abstract: Background
The new Rasamsonia spp. complex can develop invasive infection in immunosuppression or chronic pulmonary disease. It has potential to be misidentified as other genera due to morphological similarities. Nowadays, there is a gap of knowledge on this fungi.

Objectives
To provide knowledge base of risk factors and therapeutic decisions in invasive Rasamsonia spp. complex infection.

Patients/Methods
Cases of invasive infection due to Rasamsonia spp. (formerly Geosmithia /Penicillium spp.) from FungiScope® registry and all reported cases from a literature were included.

Results
We identified 23 invasive infections due to Rasamsonia spp., six (26.1%) in the FungiScope® registry. Main risk factors were chronic granulomatous disease (n = 12, 52.2%), immunosuppressive treatment (n = 10, 43.5%), haematopoietic stem cell transplantation (n = 7, 30.4%), graft‐versus‐host disease and major surgery (n = 4, 17.4%, each). Predominantly affected organs were the lungs (n = 21, 91.3%), disease disseminated in seven cases (30.4%). Fungal misidentification occurred in 47.8% (n = 11), and sequencing was used in 69.6% of the patients (n = 16) to diagnose. Breakthrough infection occurred in 13 patients (56.5%). All patients received antifungal treatment, mostly posaconazole (n = 11), caspofungin (n = 10) or voriconazole (n = 9). Combination therapy was administered in 13 patients (56.5%). Susceptibility testing showed high minimum inhibitory concentrations for azoles and amphotericin B, but not for echinocandins. No preferable treatment influencing favourable outcome was identified. Overall mortality was 39% (n = 9).

Conclusion
Rasamsonia spp. are emerging fungi causing life‐threatening infections, especially in immunocompromised and critically ill patients. Mortality is high. Treatment is challenging and clinicians dealing with this patient population should become aware of this infection constituting a medical emergency

Show object

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch
• Notes: Mycoses. - 63, 3 (2020) , 265-274, ISSN: 1439-0507

Classification and Topics

• Keyword: Filamentöse Pilze ; Immunsuppression ; Register

Contributors, Places and Time

• Event: Veröffentlichung
• (where): Freiburg
• (who): Universität
• (when): 2020
• Creator: Stemler, Jannik ; Salmanton-García, Jon ; Seidel, Danila ; Alexander, Barbara D. ; Bertz, Hartmut ; Hoenigl, Martin ; Herbrecht, Raoul ; Meintker, Lisa Marie ; Meißner, Arne Matthias Kurt ; Mellinghoff, Sibylle Christiane ; Sal, Ertan ; Zarrouk, Marouan ; Köhler, Philipp ; Cornely, Oliver Andreas

Further information

• DOI: 10.1111/myc.13039
• URN: urn:nbn:de:bsz:25-freidok-1662992
• Rights: Der Zugriff auf das Objekt ist unbeschränkt möglich.