Invasive infections due to Saprochaete and Geotrichum species: Report of 23 cases from the FungiScope Registry.
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.
Division of Infectious Diseases, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany.
Luisa
L
Durán Graeff
Division of Infectious Diseases, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany.
Danila
D
Seidel
Division of Infectious Diseases, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany.
Maria J G T
MJ
Vehreschild
Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany.
Axel
A
Hamprecht
Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Chennai, India.
Anupma
A
Kindo
Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic.
Zdenek
Z
Racil
First Department of Internal Medicine, Division of Hematology, Semmelweis University, Budapest, Hungary.
Judit
J
Demeter
CBS-KNAW, Fungal Biodiversity Centre, Utrecht, Netherlands.
Sybren
S
De Hoog
Laboratory Dr. Wisplinghoff, Cologne, Germany.
Ute
U
Aurbach
Laboratory Dr. Wisplinghoff, Cologne, Germany.
Maren
M
Ziegler
Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany.|Laboratory Dr. Wisplinghoff, Cologne, Germany.|Institute for Virology and Medical Microbiology, University Witten/Herdecke, Witten, Germany.
Hilmar
H
Wisplinghoff
Division of Infectious Diseases, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany.|Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.|German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany.|Clinical Trials Centre Cologne, ZKS Köln, Cologne, Germany.
Oliver A
http://orcid.org/0000-0001-9599-3137
OA
Cornely
D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D054714:Echinocandins / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000494:pharmacology / Q000627:therapeutic use; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005847:Geotrichosis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D005848:Geotrichum / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D000072742:Invasive Fungal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D055666:Lipopeptides / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D000077551:Micafungin; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D012042:Registries; D004718:Saccharomycetales / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D065819:Voriconazole / Q000494:pharmacology / Q000627:therapeutic use; D055815:Young Adult
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000666:Amphotericin B; D015725:Fluconazole; D065819:Voriconazole; D000077551:Micafungin

Geotrichum
; 
Saprochaete
; invasive fungal diseases