Article Dans Une Revue Clinical Infectious Diseases Année : 2025

Epidemiology and Prognostic Factors Associated With Mold-Positive Blood Cultures: 10-Year Data From a French Prospective Surveillance Program (2012–2022)

1 Hôpital Necker - Enfants Malades [AP-HP]
2 CNRMA - Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals
3 CHU Dijon
4 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
5 CHU Saint-Antoine [AP-HP]
6 HUS - Les Hôpitaux Universitaires de Strasbourg
7 PHAVI - Pathogens Host Arthropod Vectors Interfaces
8 ICANS - Institut de Cancérologie de Strasbourg Europe
9 CHU Amiens-Picardie
10 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
11 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
12 CHU Clermont-Ferrand
13 CHU Angers - Centre Hospitalier Universitaire d'Angers
14 CHU de Bordeaux Pellegrin [Bordeaux]
15 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
16 IICiMed - Cibles et Médicaments des Infections et de l'Immunité - UR 1155
17 CHU Nice [Cimiez]
18 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
19 Hôpital Robert Debré
20 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
21 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
22 CHU Pointe-à-Pitre / Abymes [Guadeloupe]
23 IGR - Institut Gustave Roussy
24 Département de biologie et pathologie médicales [Gustave Roussy]
25 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
26 CHU Montpellier = Montpellier University Hospital
27 CHRO - Centre Hospitalier Régional d'Orléans
28 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
29 Hôpital Henri Mondor
30 CHU Rouen
31 CHU Trousseau [Tours]
32 CHV - Centre Hospitalier de Versailles André Mignot
33 Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion]
34 CHU de Martinique - Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique]
35 Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
36 AP-HP - Hopital Saint-Louis [AP-HP]
Frédéric Dalle
  • Fonction : Auteur
Juliette Guitard
Taïeb Chouaki
Maxime Moniot
Vincent Dubée
Lilia Hasseine
  • Fonction : Auteur
Maud Gits-Muselli
Gilles Gargala
  • Fonction : Auteur
Laurence Millon
  • Fonction : Auteur
Mathieu Blot
  • Fonction : Auteur
Laure Vincent
  • Fonction : Auteur
Ronan Le Floch
  • Fonction : Auteur
André Paugam
  • Fonction : Auteur
Francoise Botterel
  • Fonction : Auteur
Benoît Brethon
  • Fonction : Auteur
Karen Delavigne
  • Fonction : Auteur
Aliénor Xhaard
  • Fonction : Auteur
Lucie Lelièvre
  • Fonction : Auteur
Guillaume Desoubeaux
  • Fonction : Auteur

Résumé

Background While invasive fusariosis and lomentosporiosis are known to be associated with fungemia, overall data on mold-related fungemia are limited, hampering early management. This study aimed to describe the epidemiology of mold-positive blood cultures. Methods Epidemiological and clinical data on mold-positive blood cultures from 2012 to 2022 were obtained from the RESSIF database. Pseudofungemia was excluded using modified Duthie and Denning criteria. Univariable and multivariable Firth logistical regression was used to study factors associated with 90-day mortality. Results Fusarium spp accounted for 67.5% of the 80 events, involving predominantly Fusarium fujikuroi spp complex (FFSC), Neocosmospora spp, and Fusarium oxysporum spp complex (FOSC). Lomentospora prolificans was the second most frequent (10%), followed by Trichoderma spp, Aspergillus spp, and Mucorales (5% each). Most patients had a history of hematological malignancy (HM) (70%). Forty-three percent had undergone allogeneic hematopoietic stem cell transplantation. Cutaneous and pulmonary lesions were common (43% each). Median time to blood culture positivity was 72 hours. HM and neutropenia were commonly reported in patients with FFSC, Neocosmospora spp, and L. prolificans fungemia. Pulmonary lesions were frequent in cases of L. prolificans fungemia. Patients with gastrointestinal conditions were frequently diagnosed with FOSC molds. HM (75%), particularly acute myeloblastic leukemia, was frequent in patients with Aspergillus spp fungemia. All patients with Trichoderma spp fungemia were exposed to corticosteroids. Day 90 mortality was 53%. Independent predictive factors of day 90 mortality included L. prolificans (odds ratio [OR], 33.3), Aspergillus spp fungemia (OR, 14.2), and corticosteroid exposure (OR, 7.85). Conclusions Underlying conditions and clinical presentation vary between genera and could be considered to guide early management.
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Dates et versions

pasteur-04882051 , version 1 (13-01-2025)

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Thiziri Tala-Ighil, Dea Garcia-Hermoso, Frédéric Dalle, Sophie Cassaing, Juliette Guitard, et al.. Epidemiology and Prognostic Factors Associated With Mold-Positive Blood Cultures: 10-Year Data From a French Prospective Surveillance Program (2012–2022). Clinical Infectious Diseases, In press, pp.ciae594. ⟨10.1093/cid/ciae594⟩. ⟨pasteur-04882051⟩
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