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Abstract：
UNASSIGNED: Management of Scedosporium/Lomentospora prolificans infections remains challenging. We described predisposing factors, clinical manifestations, and outcomes of these rare mold infections, including predictors of early (1-month) and late (18-month) all-cause mortality and treatment failure.
UNASSIGNED: We conducted a retrospective Australian-based observational study of proven/probable Scedosporium/L prolificans infections from 2005 to 2021. Data on patient comorbidities, predisposing factors, clinical manifestations, treatment, and outcomes up to 18 months were collected. Treatment responses and death causality were adjudicated. Subgroup analyses, multivariable Cox regression, and logistic regression were performed.
UNASSIGNED: Of 61 infection episodes, 37 (60.7%) were attributable to L prolificans. Forty-five of 61 (73.8%) were proven invasive fungal diseases (IFDs), and 29 of 61 (47.5%) were disseminated. Prolonged neutropenia and receipt of immunosuppressant agents were documented in 27 of 61 (44.3%) and 49 of 61 (80.3%) episodes, respectively. Voriconazole/terbinafine was administered in 30 of 31 (96.8%) L prolificans infections, and voriconazole alone was prescribed for 15 of 24 (62.5%) Scedosporium spp infections. Adjunctive surgery was performed in 27 of 61 (44.3%) episodes. Median time to death post-IFD diagnosis was 9.0 days, and only 22 of 61 (36.1%) attained treatment success at 18 months. Those who survived beyond 28 days of antifungal therapy were less immunosuppressed with fewer disseminated infections (both P < .001). Disseminated infection and hematopoietic stem cell transplant were associated with increased early and late mortality rates. Adjunctive surgery was associated with lower early and late mortality rates by 84.0% and 72.0%, respectively, and decreased odds of 1-month treatment failure by 87.0%.
UNASSIGNED: Outcomes associated with Scedosporium/L prolificans infections is poor, particularly with L prolificans infections or in the highly immunosuppressed population.
UNASSIGNED: We conducted a retrospective Australian-based observational study of proven/probable Scedosporium/L prolificans infections from 2005 to 2021. Data on patient comorbidities, predisposing factors, clinical manifestations, treatment, and outcomes up to 18 months were collected. Treatment responses and death causality were adjudicated. Subgroup analyses, multivariable Cox regression, and logistic regression were performed.
UNASSIGNED: Of 61 infection episodes, 37 (60.7%) were attributable to L prolificans. Forty-five of 61 (73.8%) were proven invasive fungal diseases (IFDs), and 29 of 61 (47.5%) were disseminated. Prolonged neutropenia and receipt of immunosuppressant agents were documented in 27 of 61 (44.3%) and 49 of 61 (80.3%) episodes, respectively. Voriconazole/terbinafine was administered in 30 of 31 (96.8%) L prolificans infections, and voriconazole alone was prescribed for 15 of 24 (62.5%) Scedosporium spp infections. Adjunctive surgery was performed in 27 of 61 (44.3%) episodes. Median time to death post-IFD diagnosis was 9.0 days, and only 22 of 61 (36.1%) attained treatment success at 18 months. Those who survived beyond 28 days of antifungal therapy were less immunosuppressed with fewer disseminated infections (both P < .001). Disseminated infection and hematopoietic stem cell transplant were associated with increased early and late mortality rates. Adjunctive surgery was associated with lower early and late mortality rates by 84.0% and 72.0%, respectively, and decreased odds of 1-month treatment failure by 87.0%.
UNASSIGNED: Outcomes associated with Scedosporium/L prolificans infections is poor, particularly with L prolificans infections or in the highly immunosuppressed population.
摘要：
未经授权：塞多孢子菌/多毛孢子菌感染的管理仍然具有挑战性。我们描述了诱发因素，临床表现，以及这些罕见霉菌感染的结果，包括早期（1个月）和晚期（18个月）全因死亡率和治疗失败的预测因子。
UNASSIGNED：我们从2005年至2021年对已证实/可能的塞多孢子菌/Lprolificans感染进行了一项基于澳大利亚的回顾性观察研究。关于患者合并症的数据，诱发因素,临床表现，治疗,并收集了长达18个月的结局.判定治疗反应和死亡因果关系。亚组分析，多变量Cox回归，并进行逻辑回归。
未经证实：61次感染发作，37例（60.7%）归因于Lprolificans。61人中有45人（73.8%）被证实为侵袭性真菌病（IFD），61人中有29人(47.5%)被传播。在61例中的27例（44.3％）和61例中的49例（80.3％）中记录了持续的中性粒细胞减少症和免疫抑制剂的接受。分别。伏立康唑/特比萘芬在31例（96.8％）Lprolificans感染中使用，24种（62.5％）的Scedosporium感染中有15种单独使用伏立康唑。61例发作中有27例（44.3％）进行了辅助手术。IFD诊断后的中位死亡时间为9.0天，61人中只有22人(36.1%)在18个月时获得治疗成功。抗真菌治疗存活超过28天的患者免疫抑制程度较低，播散性感染较少（均P<.001）。播散性感染和造血干细胞移植与早期和晚期死亡率增加有关。辅助手术的早期和晚期死亡率分别降低了84.0%和72.0%，分别,1个月治疗失败的几率降低了87.0%。
UNASSIGNED：与Scedosporium/Lprolificans感染相关的结果很差，特别是在Lprolificans感染或高度免疫抑制人群中。
UNASSIGNED：我们从2005年至2021年对已证实/可能的塞多孢子菌/Lprolificans感染进行了一项基于澳大利亚的回顾性观察研究。
未经证实：61次感染发作，
UNASSIGNED：与Scedosporium/Lprolificans感染相关的结果很差，
