Invasive aspergillosis due to Aspergillus section Usti: a multicenter retrospective study
Emmanouil Glampedakis
(1)
,
Sophie Cassaing
(2)
,
Arnaud Fekkar
(3)
,
Eric Dannaoui
(4)
,
Marie-Elisabeth Bougnoux
(5)
,
Stéphane Bretagne
(6)
,
Dionysios Neofytos
(7)
,
Peter Schreiber
(8)
,
Christophe Hennequin
(9)
,
Florent Morio
(10)
,
Olga Shadrivova
(11)
,
Felix Bongomin
(12)
,
Mario Fernández-Ruiz
(13)
,
Anne Pauline Bellanger
(14, 15)
,
Sevtap Arikan-Akdagli
(16)
,
Veronique Erard
(17)
,
Maria Aigner
(18)
,
Michela Paolucci
(19)
,
Nina Khanna
(20)
,
Eléna Charpentier
(2)
,
Christine Bonnal
(21)
,
Sophie Brun
(22)
,
Frédéric Gabriel
(23)
,
Arnaud Riat
(24)
,
Reinhard Zbinden
(8)
,
Patrice Le Pape
(10)
,
Nikolai Klimko
(11)
,
Russel Lewis
,
Malcolm Richardson
(25)
,
Ahmet Cagkan İnkaya
(26)
,
Alix Coste
(27)
,
Pierre-Yves Bochud
(1)
,
Frederic Lamoth
(1)
1
CHUV -
Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne]
2 Service de Parasitologie et Mycologie [CHU Toulouse]
3 CHU Pitié-Salpêtrière [AP-HP]
4 Unité de Parasitologie-Mycologie [CHU HEGP]
5 Laboratoire de Microbiologie Clinique [AP-HP Hôpital Necker-Enfants Malades]
6 Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris]
7 Hop Univ Geneve, Serv Malad Infect, Geneva, Switzerland
8 Department of Infectious Diseases and Hospital Epidemiology [Zurich]
9 CRSA - Centre de Recherche Saint-Antoine
10 IICiMed - Cibles et Médicaments des Infections et de l'Immunité - EA 1155
11 Université de Saint-Petersburg
12 University of Manchester [Manchester]
13 Unit Infectious Diseases
14 Service de parasitologie et mycologie [CHRU de Besançon]
15 LCE - Laboratoire Chrono-environnement (UMR 6249)
16 Ankara University School of Medicine [Turkey]
17 UNIFR - Université de Fribourg = University of Fribourg
18 Universität Innsbruck [Innsbruck]
19 Department of Hematology and Oncology "L. e A. Seragnoli"
20 University Hospital Basel [Basel]
21 Service de Parasitologie Mycologie[Bichat]
22 Service de Parasitologie [Avicenne]
23 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
24 Hôpitaux Universitaire de Genève
25 LRB - Radiopharmaceutiques biocliniques
26 Faculty of Medicine [Hacettepe University]
27 UNIL - Université de Lausanne = University of Lausanne
2 Service de Parasitologie et Mycologie [CHU Toulouse]
3 CHU Pitié-Salpêtrière [AP-HP]
4 Unité de Parasitologie-Mycologie [CHU HEGP]
5 Laboratoire de Microbiologie Clinique [AP-HP Hôpital Necker-Enfants Malades]
6 Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris]
7 Hop Univ Geneve, Serv Malad Infect, Geneva, Switzerland
8 Department of Infectious Diseases and Hospital Epidemiology [Zurich]
9 CRSA - Centre de Recherche Saint-Antoine
10 IICiMed - Cibles et Médicaments des Infections et de l'Immunité - EA 1155
11 Université de Saint-Petersburg
12 University of Manchester [Manchester]
13 Unit Infectious Diseases
14 Service de parasitologie et mycologie [CHRU de Besançon]
15 LCE - Laboratoire Chrono-environnement (UMR 6249)
16 Ankara University School of Medicine [Turkey]
17 UNIFR - Université de Fribourg = University of Fribourg
18 Universität Innsbruck [Innsbruck]
19 Department of Hematology and Oncology "L. e A. Seragnoli"
20 University Hospital Basel [Basel]
21 Service de Parasitologie Mycologie[Bichat]
22 Service de Parasitologie [Avicenne]
23 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
24 Hôpitaux Universitaire de Genève
25 LRB - Radiopharmaceutiques biocliniques
26 Faculty of Medicine [Hacettepe University]
27 UNIL - Université de Lausanne = University of Lausanne
Sophie Cassaing
- Fonction : Auteur
- PersonId : 1094798
- ORCID : 0000-0003-0055-0136
- IdRef : 063245000
Arnaud Fekkar
- Fonction : Auteur
- PersonId : 921964
- ORCID : 0000-0001-9954-075X
- IdRef : 110478541
Eric Dannaoui
- Fonction : Auteur
- PersonId : 756898
- IdHAL : eric-dannaoui
- ORCID : 0000-0002-2817-3830
- IdRef : 233666184
Marie-Elisabeth Bougnoux
- Fonction : Auteur
- PersonId : 758331
- ORCID : 0000-0003-4721-2740
Stéphane Bretagne
- Fonction : Auteur
- PersonId : 756896
- ORCID : 0000-0001-6870-3800
- IdRef : 076112586
Florent Morio
- Fonction : Auteur
- PersonId : 1049989
- IdHAL : florent-morio
- ORCID : 0000-0002-5859-6105
- IdRef : 117992259
Nina Khanna
- Fonction : Auteur
- PersonId : 799897
- ORCID : 0000-0002-2642-419X
Eléna Charpentier
- Fonction : Auteur
- PersonId : 1165717
Frédéric Gabriel
- Fonction : Auteur
- PersonId : 5146
- IdHAL : frederic-gabriel
- IdRef : 073432407
Patrice Le Pape
- Fonction : Auteur
- PersonId : 1164862
- ORCID : 0000-0001-5059-6402
- IdRef : 066753430
Nikolai Klimko
- Fonction : Auteur
- PersonId : 799545
- ORCID : 0000-0001-6095-7531
Russel Lewis
- Fonction : Auteur
Résumé
Background
Aspergillus spp. of section Usti (A. ustus) represent a rare cause of invasive aspergillosis (IA). This multicenter study describes the epidemiology and outcome of A. ustus infections.
Methods
Patients with A. ustus isolated from any clinical specimen were retrospectively identified in 22 hospitals from 8 countries. When available, isolates were sent for species identification (BenA/CaM sequencing) and antifungal susceptibility testing. Additional cases were identified by review of the literature. Cases were classified as proven/probable IA or no infection, according to standard international criteria.
Results
Clinical report forms were obtained for 90 patients, of whom 27 had proven/probable IA. An additional 45 cases were identified from literature review for a total of 72 cases of proven/probable IA. Hematopoietic cell and solid-organ transplant recipients accounted for 47% and 33% cases, respectively. Only 8% patients were neutropenic at time of diagnosis. Ongoing antimold prophylaxis was present in 47% of cases. Pulmonary IA represented 67% of cases. Primary or secondary extrapulmonary sites of infection were observed in 46% of cases, with skin being affected in 28% of cases. Multiple antifungal drugs were used (consecutively or in combination) in 67% of cases. The 24-week mortality rate was 58%. A. calidoustus was the most frequent causal agent. Minimal inhibitory concentrations encompassing 90% isolates (MIC90) were 1, 8, >16, and 4 µg/mL for amphotericin B, voriconazole, posaconazole, and isavuconazole, respectively.
Conclusions
Aspergillus ustus IA mainly occurred in nonneutropenic transplant patients and was frequently associated with extrapulmonary sites of infection. Mortality rate was high and optimal antifungal therapy remains to be defined.