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穗状枝孢菌和 prolificans 枝孢霉菌血症对血液恶性肿瘤患者是致命的。

Scedosporium species and Lomentospora prolificans fungaemia is uniformly fatal in patients with haematological malignancy.

机构信息

Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Queensland, Australia.

Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

出版信息

Intern Med J. 2023 Aug;53(8):1489-1491. doi: 10.1111/imj.16198.

Abstract

Scedosporium and Lomentospora species are environmental moulds that are virulent in immunocompromised hosts and rarely cause bloodstream infection (BSI). Patients with Scedosporium and Lomentospora species BSI were identified by the state public laboratory service in Queensland, Australia, over a 20-year period. Twenty-two incident episodes occurred among 21 residents; one patient had a second episode 321 days following the first. Of these, 18 were Lomentospora prolificans, three were Scedosporium apiospermum complex and one was a nonspeciated Scedosporium species. Seventeen (81%) patients died during their index admission, and all-cause mortality at 30, 90 and 365 days was 73%, 82% and 91% respectively. All 20 patients with haematological malignancy died within 365 days of follow-up with a median time to death of 9 days (interquartile range, 6-20 days) following diagnoses of BSI.

摘要

鞘孢菌属和枝孢属是环境霉菌,在免疫功能低下的宿主中具有毒性,很少引起血流感染(BSI)。在澳大利亚昆士兰州,州立公共实验室服务机构在 20 年期间确定了患有鞘孢菌属和枝孢属 BSI 的患者。21 名居民中有 22 例确诊病例,其中 1 名患者在首次发病后 321 天出现第二次发病。其中,18 例为枝孢属繁枝变种,3 例为帚梗枝孢复合种,1 例为未分种的枝孢属。17 例(81%)患者在住院期间死亡,30、90 和 365 天的全因死亡率分别为 73%、82%和 91%。所有 20 例患有血液系统恶性肿瘤的患者在随访 365 天内死亡,BSI 确诊后中位死亡时间为 9 天(四分位间距,6-20 天)。

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