Scedosporiosis/lomentosporiosis observational study (SOS): Clinical significance of Scedosporium species identification

Didier Bronnimann (1, 2, 3) , Dea Garcia-Hermoso (4, 5) , Françoise Dromer (4, 5) , Fanny Lanternier (6, 4, 3, 5) , Laurence Maulin , Yves Leprince , Nathalie Brieu (7) , Berengere Gruson , Youssef El-Samad , Taieb Chouaki (8) , Sophie Bayle , Cécile Jensen , Stéphanie Branger , Grégoire Leclerc , Laurent Hustache-Mathieu , Fabrice Larosa , Frédéric Grenouillet , Diane Bouvry , Frédéric Mechai , Sophie Brun , Frédéric Villega , Hervé Dutronc , Jean-François Velly , Laurence Delhaes , Frederic Gabriel , Nicolas Paleiron , Laurence Di Costanzo Pougnet , Anne de Tinteniac , Luc Quaesaet , Liana Carausu , Gaelle Guillerm , Lenaïg Le Clech , Gilles Nevez , Julie Bonhomme , Cécile Molucon-Chabrot , Jacques-Olivier Bay , Céline Nourrisson , Philippe Poirier , Agnes Lefort , Véronique Leflon-Guibout , Catherine Cordonnier , Nicolas Limal , Françoise Botterel-Chartier , Hôpital Henri Mondor , Philippe Zann , Benoit Roze , Nicole Desbois , Lelia Escaut , Jean-François Papon , Adela Angoulvant , Kamel Laribi , Pascale Penn , Pascal Turlure , Thomas Daix , Boris Melloni , Bernard Bouteille , Thomas Perpoint , Florence Ader , Marie Balsat , Florence Persat , Jean-Marie Forel , Valérie Moal , Stéphane Ranque , Cristina Audoly , Delphine Lancement , Caroline Fritz , Joséphine Dorin , Marie Machouart , David Boutoille , Jérémie Orain , Delphine Horeau-Langlard , Florent Morio , Olivier Moquet , Viviane Queyrel-Moranne , Lionel Mannone , Pierre-Marie Roger , Martine Gari-Toussaint , Lilia Hasseine , Giovanna Ingenuo , Nicolas Durrleman , Nina Arakelyan-Laboure , Didier Poisson , Marine Paul , Frederic Pene , André Paugam , Valérie Zeller , Beate Heym , Romain Guillemain , Yoann Prevot , Eric Dannaoui , Pierre Frange , Stéphane Blanche , Felipe Suarez , Anne Scemla , Romain Guery , Olivier Lortholary , Marie-Elisabeth Bougnoux , Thomas Similowski , Eric Caumes , Arnaud Fekkar , Ana Presedo , Patricia Mariani , Nicolas Engrand , Flore Sicre de Fontbrune , Philippe Herman , Alexandre Alanio , Stéphane Bretagne , Rachel Brault , Blandine Rammaert , Catherine Kauffmann-Lacroix , Alain Delmer , Violaine Noel , Dominique Toubas , Antoine Huguenin , Matthieu Revest , Sorya Belaz , Jean-Pierre Gangneux , Céline Dieval , Isabelle Degasne , Nicolas Traversier , Claire Briere-Bellier , Patrick Lutz , Françoise Uettwiller , Raoul Herbrecht , Valérie Letscher-Bru , Emilie Catherinot , Louis-Jean Couderc , Elizabeth Rivaud , Pierre Cahen , François Bissuel , Muriel Alvarez , Guillaume Martin-Blondel , Morgane Mourguet , Emmanuelle Mouchon , Anne Huynh , Noémie Gadaud , Joelle Guitard , Xavier Iriart , Sophie Cassaing , Christophe Joubert , Frédéric Janvier , Audrey Berric , Jacques Grill , Florence Pasquier , Stéphane de Botton , Elisabeth Chachaty , Anne Boullié , Cécile Gautier , Audrey Hessel , Damien Hoinard , Dorothée Raoux-Barbot , The French Mycoses Study Group

1 CHU Necker - Enfants Malades [AP-HP]
2 Université Victor Segalen - Bordeaux 2
3 UPCité - Université Paris Cité
4 Mycologie moléculaire - Molecular Mycology
5 CNRMA - Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals
6 Centre d'infectiologie Necker-Pasteur [CHU Necker]
7 Centre Hospitalier du Pays d'Aix
8 CHU Amiens-Picardie

Scedosporiosis/lomentosporiosis is a devastating emerging fungal infection. Our objective was to describe the clinical pattern and to analyze whether taxonomic grouping of the species involved was supported by differences in terms of clinical presentations or outcomes. We retrospectively studied cases of invasive scedosporiosis in France from 2005 through 2017 based on isolates characterized by polyphasic approach. We recorded 90 cases, mainly related to Scedosporium apiospermum (n = 48), S. boydii/S. ellipsoideum (n = 20), and Lomentospora prolificans (n = 14). One-third of infections were disseminated, with unexpectedly high rates of cerebral (41%) and cardiovascular (31%) involvement. In light of recent Scedosporium taxonomic revisions, we aimed to study the clinical significance of Scedosporium species identification and report for the first time contrasting clinical presentations between infections caused S. apiospermum, which were associated with malignancies and cutaneous involvement in disseminated infections, and infections caused by S. boydii, which were associated with solid organ transplantation, cerebral infections, fungemia, and early death. The clinical presentation of L. prolificans also differed from that of other species, involving more neutropenic patients, breakthrough infections, fungemia, and disseminated infections. Neutropenia, dissemination, and lack of antifungal prescription were all associated with 3-month mortality. Our data support the distinction between S. apiospermum and S. boydii and between L. prolificans and Scedosporium sp. Our results also underline the importance of the workup to assess dissemination, including cardiovascular system and brain. Lay Summary Scedosporiosis/lomentosporiosis is a devastating emerging fungal infection. Our objective was to describe the clinical pattern and to analyze whether taxonomic grouping of the species involved was supported by differences in terms of clinical presentations or outcomes.

Keywords: Scedosporium sp; scedosporiosis; Scedosporium sp.; Lomentospora prolificans; outcome; cardiovascular localization; Scedosporium sp

Domains: Mycology

Didier Bronnimann, Dea Garcia-Hermoso, Françoise Dromer, Fanny Lanternier, Laurence Maulin, et al.. Scedosporiosis/lomentosporiosis observational study (SOS): Clinical significance of Scedosporium species identification. Medical Mycology, 2020, 59 (5), pp.486 - 497. ⟨10.1093/mmy/myaa086⟩. ⟨pasteur-03222501⟩