gms | German Medical Science

Frühjahrstagung der Sektion Antimykotische Chemotherapie 2017

Paul-Ehrlich-Gesellschaft für Chemotherapie (PEG e. V.)

17. - 18.03.2017, Bonn

Fusarium cases in Vienna – A retrospective analysis in a tertiary care hospital from 2007–2016

Meeting Abstract

  • corresponding author Alexander Tolios - Medical University Vienna, Department of Laboratory Medicine, Division of Clinical Microbiology, Vienna
  • Iris Zeller - Medical University Vienna, Department of Laboratory Medicine, Division of Clinical Microbiology, Vienna
  • Brigitte Selitsch - Medical University Vienna, Department of Laboratory Medicine, Division of Clinical Microbiology, Vienna
  • Marion Nehr - Medical University Vienna, Department of Laboratory Medicine, Division of Clinical Microbiology, Vienna
  • Wolfgang Barousch - Medical University Vienna, Department of Laboratory Medicine, Division of Clinical Microbiology, Vienna
  • Birgit Willinger - Medical University Vienna, Department of Laboratory Medicine, Division of Clinical Microbiology, Vienna

Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG). Frühjahrstagung der Sektion Antimykotische Chemotherapie 2017. Bonn, 17.-18.03.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. Doc17sac22

doi: 10.3205/17sac22, urn:nbn:de:0183-17sac229

Published: March 13, 2017

© 2017 Tolios et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Besides Fusarium being a fungal genus commonly affecting plants, cases of human fusariosis are known. In the last decades, the number of fusariosis has been on the rise, often due to contact lens-associated keratitis or patients with immunodeficiency or immunosuppression after organ transplantation. For the identification of different Fusarium strains, micro- and macromorphology is helpful, but genetic analysis is often required.

For this project we evaluated all cases of Fusarium infections at the General Hospital of Vienna (Medical University of Vienna) since 2007. Samples (e.g. blood cultures, contact lenses, body fluids and biopsies) were sent to the Department of Laboratory Medicine, Division of Clinical Microbiology. Specimens were inoculated on to Sabouraud dextrose agar (Oxoid, Basingstoke, UK) and brain heart infusion agar (BD, Heidelberg, Germany) and incubated for 3 weeks at 30 and 35°C. Identification was performed using micro- and macromorphological aspects and confirmed by sequencing. In addition, the history of all patients was reviewed.

We collected 50 isolates from 33 different patients since 2007. The patients’ mean age was 43 years. Most infections were contact lens-associated and isolated either from the contact lens fluid (33%) or directly from the eye (12%). 18% of Fusarium isolates were collected from wounds or surgical sites, 18% were taken from broncho-alveolar lavage (BAL) fluids or sputum from patients after lung transplantation. Fusarium strains were mostly F. oxysporum (45%), followed by F. solani (27%) and other less common strains (F. chlamydosporum, F. proliferarum, F. dimerum), although isolates from BAL fluids and surgical sites were predominantly caused by F. solani. When using the E-test (BioMerieux, France), most specimen showed low minimal inhibitory concentrations (MIC) to voriconazole and amphotericin B, although some resistant isolates were found. MICs to fluconazole, itraconazole and posaconazole were consistently high. Since there are no clinical breakpoints established it is difficult to determine where resistance begins. When only a localized infection was present (approx. 80% of cases) all patients survived. Patients with non-localized, disseminated fungal infections had a poor outcome.

Although being rare, we could find 3–6 cases of Fusarium infections in humans each year at the General Hospital of Vienna (Medical University of Vienna). Most cases (75% of infections) are caused by F. oxysporum or F. solani. Approximately 45% of all Fusarium infections are localized contact lens-associated infections with a good overall survival prognosis.