Population-based surveillance for scedosporiosis in Australia: epidemiology, disease manifestations and emergence of Scedosporium aurantiacum infection.
Australia-wide population-based surveillance for scedosporiosis identified 180 cases, with 118 (65.6%) cases of colonization and 62 (34.4%) cases of infection. Predisposing factors for isolation of Scedosporium spp. included chronic lung disease in 37.8% and malignancy in 21.7% of cases. Predictors of invasive disease (n=62) included haematological stem cell transplantation (n=7), leukaemia (n=16) and diabetes mellitus (n=8). Of 183 phenotypically-speciated isolates, 75 (41%) were Scedosporium prolificans (risk factors: haematologic cancer (n=17), neutropaenia (n=14)) and 108 (59%) had Scedosporium apiospermum/Pseudallescheria boydii phenotype [risk factor: diabetes (n=15)]. Scedosporium prolificans (p 0.01) and leukaemia (p 0.03) independently predicted death. Epidemiological and antifungal susceptibility profiles of Scedosporium aurantiacum (prevalence>or=15.8%) and S. apiospermum were similar. No patient with S. aurantiacum infection (n=6) died. This is the first description of clinical features associated with S. aurantiacum.
Heath
C H
CH
Department of Microbiology and Infectious Diseases, Royal Perth Hospital, University of Western Australia, Perth, WA, Australia.
Slavin
M A
MA
Sorrell
T C
TC
Handke
R
R
Harun
A
A
Phillips
M
M
Nguyen
Q
Q
Delhaes
L
L
Ellis
D
D
Meyer
W
W
Chen
S C A
SC
D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008271:Mycetoma / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology*; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D021681:Scedosporium / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D055815:Young Adult
D000935:Antifungal Agents