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Trichosporon species bloodstream infections in a tertiary care hospital in the western region of Saudi Arabia: A 7-year retrospective chart review from 2016 to 2022

Summary

This study examined a rare but dangerous fungal infection called Trichosporonosis that affects the bloodstream in hospitalized patients. Researchers found that this infection kills about 60% of patients despite treatment with antifungal medications. The infection is often caused by a fungus called Trichosporon asahii and typically occurs in patients with weakened immune systems who are already hospitalized and using catheters.

Background

Invasive Trichosporon spp. infections are emerging opportunistic fungal pathogens associated with high mortality rates, particularly in immunocompromised patients. These infections are often challenging to diagnose and resistant to conventional antifungal treatments, contributing to significant morbidity and mortality in tertiary care settings.

Objective

This study aims to describe the risk factors, patient characteristics, antifungal susceptibility patterns, and clinical outcomes of Trichosporon bloodstream infections at a tertiary care hospital in Saudi Arabia over a 7-year period.

Results

Ten patients with Trichosporon spp. bloodstream infections were identified with a mean age of 58.1 years (70% male). Trichosporon asahii predominated in 90% of isolates. Four patients were cured (40%), with two receiving voriconazole monotherapy and two receiving combination therapy with liposomal amphotericin B plus voriconazole. All-cause 30-day mortality was 60%, with three deaths occurring before isolate identification.

Conclusion

Trichosporon fungemia remains an uncommon but highly lethal invasive fungal infection with a 60% mortality rate and predominance of T. asahii. Management challenges including delayed diagnosis, antifungal resistance, and breakthrough fungemia underscore the need for improved diagnostic strategies and optimized treatment protocols to enhance patient outcomes.
  • Published in:Medical Mycology,
  • Study Type:Retrospective Chart Review,
  • Source: PMID: 40234213, DOI: 10.1093/mmy/myaf029
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