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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 rare but serious fungal infections caused by Scedosporium and Lomentospora in lung transplant patients. Of 576 transplant recipients, 11 (2%) developed these infections, which are difficult to treat due to natural resistance to most antifungal medications. The infection type greatly influenced outcomes, with disseminated Lomentospora infections causing 100% mortality despite treatment. The research highlights the urgent need for new diagnostic methods and more effective antifungal drugs to combat these emerging pathogens.

Background

Scedosporium spp. and Lomentospora prolificans are emerging fungal pathogens that cause difficult-to-treat infections in immunocompromised patients. Lung transplant recipients are particularly susceptible due to continuous graft exposure to air and profound immunosuppression required to prevent rejection.

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 susceptibility.

Results

Eleven patients (2%) had Scedosporium/Lomentospora isolation: 4 colonizations and 7 infections. Five pulmonary infections and two disseminated infections were identified. S. apiospermum complex was most common in pulmonary disease while L. prolificans predominated in disseminated disease. Mortality was 50% for L. prolificans colonization and 100% for disseminated disease.

Conclusion

Scedosporium and Lomentospora infections are infrequent but associated with high morbidity and mortality. New diagnostic and therapeutic tools are urgently needed to improve outcomes, particularly for disseminated L. prolificans infections.
  • Published in:Journal of Fungi,
  • Study Type:Retrospective Cohort Study,
  • Source: PMID: 40278112, DOI: 10.3390/jof11040291
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