gms | German Medical Science

Background: The incidence of invasive fungal infections is increasing in all parts of the world. Increasing numbers of immunocompromised patients are a major contributing factor. Less common emerging fungal pathogens account for significant numbers of these invasive infections. Invasive trichosporonosis is one example of an emerging fungal pathogen. To date, the epidemiology is largely unknown and current treatment recommendations cannot be considered evidence based. For this orphan disease, significant numbers of cases for systematic analysis cannot be collected in one center alone. Therefore, “TriReg – A Europewide Study of Trichosporonosis” has been launched as an ECMM Working Group in April 2013. The objective of the study is to improve the knowledge on epidemiology, clinical course, biology, and pathomechanisms of trichosporonosis in order to develop evidencebased recommendations for diagnosis and treatment.

Methods: TriReg uses web-based data capture via www.ecmm.eu. For case enrolment cultural, histological, or molecular evidence of invasive trichosporonosis is required. In addition to demographic and clinical data, isolates are collected and formal identification and susceptibility testing are performed.

Results: In the first 6 months since the launch of the project 6 cases of trichosporonosis were documented, 2 of these were considered invalid as there was insufficient evidence of invasive infection. Of the 4 remaining cases, 3 patients were male. They originated from 3 different European countries. 3 Patient had received chemotherapy and 2 patients were treated in ICU and had prosthetic material in place, respectively. 3 of the 4 patients experienced disseminated infection documented by positive blood cultures, but in 2 patients there was additional localized evidence of infection. Outcome was poor and 3 of the 4 patients died, all of them due to the fungal infection.

Conclusion: Invasive trichosporonosis is a rare disease with a very poor prognosis. Within the first few months after the launch of the registry a small number of cases from 3 different countries could already be collected. A joint international effort is required to advance the knowledge on this orphan disease in order to improve patient care. TriReg provides a platform to achieve this goal and new contributors are invited to participate!

Keywords: trichosporonosis, web-based registry, invasive fungal infection