Invasive Trichoderma spp. infections: clinical presentation and outcome of cases from the literature and the FungiScope(R) registry

SAL, Ertan, Jannik STEMLER, Jon SALMANTON-GARCIA, Iker FALCES-ROMERO, Laszlo KREDICS, Elisabeth MEYER, Benjamin WUERSTL, Cornelia LASS-FLOERL, Zdeněk RÁČIL, Nikolay KLIMKO, Simone CESARO, Anupma Jyoti KINDO, Hilmar WISPLINGHOFF, Philipp KOEHLER, Oliver A. CORNELY and Danila SEIDEL. Invasive Trichoderma spp. infections: clinical presentation and outcome of cases from the literature and the FungiScope(R) registry. Journal of Antimicrobial Chemotherapy. OXFORD: Oxford University Press, 2022, vol. 77, No 10, p. 2850-2858. ISSN 0305-7453. Available from: https://dx.doi.org/10.1093/jac/dkac235.

Basic information

• Original name: Invasive Trichoderma spp. infections: clinical presentation and outcome of cases from the literature and the FungiScope(R) registry
• Authors: SAL, Ertan, Jannik STEMLER, Jon SALMANTON-GARCIA, Iker FALCES-ROMERO, Laszlo KREDICS, Elisabeth MEYER, Benjamin WUERSTL, Cornelia LASS-FLOERL, Zdeněk RÁČIL (203 Czech Republic, belonging to the institution), Nikolay KLIMKO, Simone CESARO, Anupma Jyoti KINDO, Hilmar WISPLINGHOFF, Philipp KOEHLER, Oliver A. CORNELY and Danila SEIDEL (guarantor).
• Edition: Journal of Antimicrobial Chemotherapy, OXFORD, Oxford University Press, 2022, 0305-7453.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30104 Pharmacology and pharmacy
• Country of publisher: United Kingdom of Great Britain and Northern Ireland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 5.200
• RIV identification code: RIV/00216224:14110/22:00126680
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1093/jac/dkac235
• UT WoS: 000836090400001
• Keywords in English: Invasive Trichoderma spp. infections
• Tags: 14110515, rivok
• Tags: International impact, Reviewed

Abstract

Background Trichoderma spp. are filamentous fungi causing invasive fungal diseases in patients with haematological malignancies and in peritoneal dialysis patients. Objectives To analyse clinical presentation, predisposing factors, treatment and outcome of Trichoderma infections. Methods A systematic literature review was conducted for published cases of invasive Trichoderma infection in PubMed until December 2021 and by reviewing the included studies' references. Cases from the FungiScope(R) registry were added to a combined analysis. Results We identified 50 invasive infections due to Trichoderma species, including 11 in the FungiScope(R) registry. The main underlying conditions were haematological malignancies in 19 and continuous ambulatory peritoneal dialysis (CAPD) in 10 cases. The most prevalent infection sites were lung (42%) and peritoneum (22%). Systemic antifungal therapy was administered in 42 cases (84%), mostly amphotericin B (n = 27, lipid-based formulation 13/27) and voriconazole in 15 cases (30%). Surgical interventions were performed in 13 cases (26%). Overall mortality was 48% (n = 24) and highest for allogeneic HSCT and solid organ transplantation (SOT) recipients [80% (4/5) and 77% (7/9), respectively]. In patients treated with amphotericin B, voriconazole and caspofungin, mortality was 55% (15/27), 46% (7/15) and 28% (2/7), respectively. Three out of four patients treated with a combination therapy of voriconazole and caspofungin survived. Conclusions Despite treatment with antifungal therapies and surgery, invasive Trichoderma infections are life-threatening complications in immunocompromised patients, especially after HSCT and SOT. In addition, Trichoderma spp. mainly affect the lungs in patients with haematological malignancies and the peritoneum in CAPD patients.