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Clinical Significance and Therapeutic Challenges of Scedosporium spp. and Lomentospora prolificans Isolates in a Single-Center Cohort of Lung Transplant Recipients

Summary

This study examined dangerous fungal infections caused by Scedosporium and Lomentospora species in lung transplant patients at a Spanish hospital. Researchers found these infections were uncommon but very serious, with high death rates especially from the Lomentospora type. Current antifungal drugs often don’t work well against these fungi, highlighting the need for better treatment options.

Background

Emerging fungal infections caused by Scedosporium spp. and Lomentospora prolificans are increasingly frequent and difficult to treat in lung transplant recipients. The constant exposure of lung grafts to the external environment and high immunosuppression required for preventing rejection are major predisposing factors for these infections.

Objective

To analyze the frequency and management of Scedosporium spp. and Lomentospora prolificans isolates in lung transplant recipients, assess patient outcomes, and evaluate in vitro antifungal sensitivity profiles.

Results

Eleven patients (2%) had Scedosporium spp. or Lomentospora prolificans isolations; 36% were colonization and 64% were infection. Five infections were pulmonary and two were disseminated. Voriconazole and terbinafine were the most frequently used antifungal drugs. The mortality rate for Lomentospora prolificans was 50% for colonization and 100% for disseminated disease.

Conclusion

Scedosporium spp. and Lomentospora prolificans infections are associated with high morbidity and mortality rates in lung transplant recipients. New diagnostic and therapeutic tools are urgently needed to improve outcomes and reduce the impact of these difficult-to-treat infections.
  • Published in:Journal of Fungi (Basel),
  • Study Type:Retrospective Observational Study,
  • Source: PMID: 40278112, DOI: 10.3390/jof11040291
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