Invasive Trichosporon Infection in Pediatric Patients; results from the first national study from Turkey

Abstract Background : Invasive Trichosporon infections is a rare and opportunistic fungal infection in children that mainly affects immunocompromised patients. This multicenter retrospective study was rewieved the characteristics, risk factors, treatment modalities and outcome of invasive Trichosporon species in children diagnosed over the past ten years in Turkey. Methods : In the study 12 of 55 hospitals invited from Turkey participated. In each center, the patients with Trichosporon species associated bloodstream infections during the period of January 2010 and December 2020 were retrospectively ascertained and reported to the study coordinator by means of a simple case report. Data were collected on patient demographics, underlying condition, Trichosporon species, management, treatment and 7 to 30 day mortality. Results : A total of 28 cases with Trichosporon species fungemia were included. The most common underlying disease was pediatric cancers (39.3%). Among the Trichosporon isolation, 22(78.5%) isolations were defined as T. asahii infections. A various spectrum of antifungal treatment regiments included intravenous amphotericin B alone at 35.7% of the patients, intravenous amphotericin B and voriconazole combination at 32.1% and intravenous voriconazole alone at 28.6%. The overall mortality rate was 28.5 %. The mortality rate was 12.5% in the voricanozole arm, 30% in the amphotericin B arm and 33.3% in voriconazole and amphotericin B combination group. Conclusions : Invasive Trichosporon infections were significant with an overall mortality rate of 28.5% and almost related to the underlying disease. Voriconazol was found to be associated with lower mortality rates comparing to other treatment regiments.