Scedosporiosis in a Tertiary Care Cancer Center in the Past 16 Years

G.A. LAMARIS, MD, G. CHAMILOS, MD, R.E. LEWIS, PharmD, A. SAFDAR, MD, I.I. RAAD, MD, D. P. KONTOYIANNIS, MD;

Author address: 

UT MD Anderson Cancer Center, Houston, TX.

Abstract: 

Background: SCD is a rare opportunistic mycosis with poor outcome. The recent introduction of agents with poor activity against Scedosporium spp, raises concerns whether SCD would be frequently encountered as breakthrough infection in the future. As they are few data regarding SCD, a review is timely. Methods: We identified cases of SCD (caused by either Scedosporium apiospermum (Sc. ap) or Scedosporium prolificans (Sc. pr) (EORTC/MSG criteria) by reviewing the microbiology and autopsy reports (19892006). We retrospectively obtained information related to malignancy, clinical characteristics, antifungal prophylaxis treatment and outcome. Incidence rates (100.000 pt-inpatient days) were calculated (19932005). Results: Of the 50 cancer patients (pts) with a positive culture for Scedosporium, 24 (all with hematologic malignancy, BMT in 11, 46%) met criteria for SCD (20 with Sc. ap, 4 with Sc. pr); 26 pts (with solid tumors 18, 69%) had colonization by Scedosporium spp. The overall incidence was 1.11/100.000 pt-days. The incidence of SCD increased from 0.82 in 19931998 to 1.33 in 19992005 ( p = 0.006). Cases of S.pr were only seen after 2000 (1 case in 2001 and 2005, 2 in 2006). The majority of pts were lymphopenic (21, 88%), neutropenic (13, 53%), had diabetes (14, 58%), or active malignancy (13, 54%). Most (20, 83%) had received prior steroids and had serum albumin
2006

abstract No: 

554

Full conference title: 

Infectious Diseases Society of America, 44th Annual Meeting
    • IDSA 44th