Current Epidemiology and Infection Characteristics of Non-Aspergillus Mold Infections: A Multicenter Study in Australia and New Zealand.
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Neoh Chin Fen, Chen Sharon C A, Morris Arthur J, Heath Christopher H, Tan Shu Jin, Lane Rebekah, Tio Shio Yen, Tay Sze Yen, Roberts Matthew B, Kennedy Karina, van Hal Sebastiaan J, Murray Hugh C, Pickles Robert, Vaselli Natasha Marcella, Douglas Abby, Urbancic Karen, Menon Mahesh, Stewart Adam, Howard Julia C, Keighley Caitlin, Miyakis Spiros, Beresford Rohan, Cooley Louise, Sehu Marjoree, Halliday Catriona L, Kidd Sarah, Kong David C M, Spelman Tim, Worth Leon J, Slavin Monica A, Australian and New Zealand Study Group for non-Aspergillus Mold Infections
Аннотация
METHODS: A 21-center, retrospective study of proven/probable non-Aspergillus mold infections from 2016 to 2023 was conducted in Australia and New Zealand. Data collected included demographic, clinical, microbiological, treatment, and outcome information through 180 days of follow-up.
RESULTS: Of 421 cases, 346 (82.2%) were proven infections and 315 (74.8%) were localized. Lung (n = 150, 35.6%) was the most common site of infection. Twenty cases (4.8%) were due to >1 non-Aspergillus mold pathogen, resulting in 443 isolates in total. Dematiaceous molds, inclusive of Lomentospora prolificans (n = 96 of 443, 21.7%), Scedosporium spp. (n = 87 of 443, 19.6%), and other dematiaceous molds of various genera (n = 48 of 443, 10.8%), were the most common (n = 231 of 443, 52.1%), followed by Mucorales (n = 141 of 443, 31.8%). Common underlying conditions were hematological malignancy (n = 146, 34.7%) and diabetes mellitus (n = 122, 29.0%), while 68 cases (16.2%) had no comorbidities. One-third (n = 138, 32.8%) of patients received antifungal prophylaxis 30 days before non-Aspergillus mold diagnosis, and L. prolificans was the most common cause of breakthrough infections (P < .001). All-cause 90-day mortality was 31.4% (n = 132 of 421), with higher mortality observed in L. prolificans (n = 51 of 89, 57.3%) and Mucorales (n = 56 of 129, 43.4%) infections.
CONCLUSIONS: Lomentospora prolificans, Scedosporium spp., and Mucorales are the most frequent non-Aspergillus mold pathogens in Australasia, with other emerging species and mixed infections encountered. Mortality from L. prolificans and Mucorales infections remains high.