Invasive infections with Purpureocillium lilacinum: clinical characteristics and outcome of 101 cases from FungiScope (R) and the literature
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F21%3A10428500" target="_blank" >RIV/00216208:11110/21:10428500 - isvavai.cz</a>
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=DeqKwEuACh" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=DeqKwEuACh</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1093/jac/dkab039" target="_blank" >10.1093/jac/dkab039</a>
Alternative languages
Result language
angličtina
Original language name
Invasive infections with Purpureocillium lilacinum: clinical characteristics and outcome of 101 cases from FungiScope (R) and the literature
Original language description
Objectives: To provide a basis for clinical management decisions in Purpureocillium lilacinum infection. Methods: Unpublished cases of invasive P. lilacinum infection from the FungiScope (R) registry and all cases reported in the literature were analysed. Results: We identified 101 cases with invasive P. lilacinum infection. Main predisposing factors were haematological and oncological diseases in 31 cases (30.7%), steroid treatment in 27 cases (26.7%), solid organ transplant in 26 cases (25.7%), and diabetes mellitus in 19 cases (18.8%). The most prevalent infection sites were skin (n = 37/101, 36.6%) and lungs (n = 26/101, 25.7%). Dissemination occurred in 22 cases (21.8%). Pain and fever were the most frequent symptoms (n = 40/101, 39.6% and n = 34/101, 33.7%, respectively). Diagnosis was established by culture in 98 cases (97.0%). P. lilacinum caused breakthrough infection in 10 patients (9.9%). Clinical isolates were frequently resistant to amphotericin B, whereas posaconazole and voriconazole showed good in vitro activity. Susceptibility to echinocandins varied considerably. Systemic antifungal treatment was administered in 90 patients (89.1%). Frequently employed antifungals were voriconazole in 51 (56.7%) and itraconazole in 26 patients (28.9%). Amphotericin B treatment was significantly associated with high mortality rates (n = 13/33, 39.4%, P = <0.001). Overall mortality was 21.8% (n = 22/101) and death was attributed to P. lilacinum infection in 45.5%(n = 10/22). Conclusions: P. lilacinum mainly presents as soft-tissue, pulmonary or disseminated infection in immuno-compromised patients. Owing to intrinsic resistance, accurate species identification and susceptibility testing are vital. Outcome is better in patients treated with triazoles compared with amphotericin B formulations.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30205 - Hematology
Result continuities
Project
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Continuities
V - Vyzkumna aktivita podporovana z jinych verejnych zdroju
Others
Publication year
2021
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Journal of Antimicrobial Chemotherapy
ISSN
0305-7453
e-ISSN
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Volume of the periodical
76
Issue of the periodical within the volume
6
Country of publishing house
GB - UNITED KINGDOM
Number of pages
11
Pages from-to
1593-1603
UT code for WoS article
000654741700028
EID of the result in the Scopus database
2-s2.0-85106541013