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Differences of clinical characteristics and outcome in proven invasive Trichosporon infections caused by asahii and non-asahii species

 Eun Hwa Lee  ;  Min Hyuk Choi  ;  Kyoung Hwa Lee  ;  Young Goo Song  ;  Sang Hoon Han 
 MYCOSES, Vol.66(11) : 992-1002, 2023-11 
Journal Title
Issue Date
Antifungal Agents / therapeutic use ; Humans ; Neutropenia* / drug therapy ; Retrospective Studies ; Trichosporon* ; Trichosporonosis* / drug therapy
Trichosporon asahii ; Trichosporonosis ; invasive yeast infection ; mortality ; species
Background: Trichosporon is an emerging yeast that causes invasive infections in immunocompromised patients experiencing prolonged hospitalisation, indwelling venous catheters and neutropenia.

Methods: This retrospective observational cohort study analysed invasive Trichosporon infections (ITIs) occurring between January 2005 and December 2022 at three tertiary hospitals and compared the clinical characteristics and prognostic factors of ITIs caused by Trichosporon asahii and non-T. asahii spp. After evaluating 1067 clinical isolates, we identified 46 patients with proven ITIs, defined as cases in which Trichosporon was isolated from blood, cerebrospinal fluid, or sterile tissues.

Results: The patients were separated into T. asahii and non-T. asahii groups containing 25 and 21 patients, respectively, all of which except one were immunocompromised. During this period, both the number of clinical isolates and patients with ITIs (mainly T. asahii) increased; whereas, cases involving non-T. asahii spp. decreased. Compared with the non-T. asahii group, the T. asahii group had more patients with multiple catheters (84% vs. 33%, p = .001) and those receiving renal replacement therapy (48% vs. 14%, p = .005). The all-cause 28-day mortality rate after ITI in the T. asahii group (44%) was significantly higher than in the non-T. asahii group (10%, Log-rank p = .014). The multivariate Cox regression model revealed that T. asahii (reference, non-T. asahii spp.; aHR = 4.3; 95% CI = 1.2-15.2, p = .024) and neutropenia for 5 days or more (aHR = 2.2, 95% CI = 1.5-3.6, p = .035) were independent factors in the 28-day mortality after ITI.

Conclusion: The proven ITIs due to T. asahii produced more unfavourable outcomes compared with ITIs caused by non-T. asahii spp.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Lee, Kyoung Hwa(이경화) ORCID logo https://orcid.org/0000-0003-0033-1398
Lee, Eun Hwa(이은화)
Choi, Min Hyuk(최민혁) ORCID logo https://orcid.org/0000-0001-9801-9874
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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