Scedosporiosis/lomentosporiosis observational study (SOS): Clinical significance of Scedosporium species identification
Authors: Bronnimann Didier , Garcia-Hermoso Dea , Dromer Françoise , Lanternier Fanny ,   The French Mycoses Study Group, Maulin Laurence , Leprince Yves , Brieu Nathalie , Gruson Berengere , El-Samad Youssef , Chouaki Taieb , Bayle Sophie , Jensen Cécile , Branger Stéphanie , Leclerc Grégoire , Hustache-Mathieu Laurent , Larosa Fabrice , Grenouillet Frédéric , Bouvry Diane , Mechai Frédéric , Brun Sophie , Villega Frédéric , Dutronc Hervé , Velly Jean-François , Delhaes Laurence , Gabriel Frederic , Paleiron Nicolas , Di Costanzo Pougnet Laurence , De Tinteniac Anne , Quaesaet Luc , Carausu Liana , Guillerm Gaelle , Le Clech Lenaïg , Nevez Gilles , Bonhomme Julie , Molucon-Chabrot Cécile , Bay Jacques-Olivier , Nourrisson Céline , Poirier Philippe , Lefort Agnes , Leflon-Guibout Véronique , Cordonnier Catherine , Limal Nicolas , Botterel-Chartier Françoise , Henri Mondor Hôpital , Zann Philippe , Roze Benoit , Desbois Nicole , Escaut Lelia , Papon Jean-François , Angoulvant Adela , Laribi Kamel , Penn Pascale , Turlure Pascal , Daix Thomas , Melloni Boris , Bouteille Bernard , Perpoint Thomas , Ader Florence , Balsat Marie , Persat Florence , Forel Jean-Marie , Moal Valérie , Ranque Stéphane , Audoly Cristina , Lancement Delphine , Fritz Caroline , Dorin Joséphine , Machouart Marie , Boutoille David , Orain Jérémie , Horeau-Langlard Delphine , Morio Florent , Moquet Olivier , Queyrel-Moranne Viviane , Mannone Lionel , Roger Pierre-Marie , Gari-Toussaint Martine , Hasseine Lilia , Ingenuo Giovanna , Durrleman Nicolas , Arakelyan-Laboure Nina , Poisson Didier , Paul Marine , Pene Frederic , Paugam André , Zeller Valérie , Heym Beate , Guillemain Romain , Prevot Yoann , Dannaoui Eric , Frange Pierre , Blanche Stéphane , Suarez Felipe , Scemla Anne , Guery Romain , Lortholary Olivier , Bougnoux Marie-Elisabeth , Similowski Thomas , Caumes Eric , Fekkar Arnaud , Presedo Ana , Mariani Patricia , Engrand Nicolas , De Fontbrune Flore Sicre , Herman Philippe , Alanio Alexandre , Bretagne Stéphane , Brault Rachel , Rammaert Blandine , Kauffmann-Lacroix Catherine , Delmer Alain , Noel Violaine , Toubas Dominique , Huguenin Antoine , Revest Matthieu , Belaz Sorya , Gangneux Jean-Pierre , Dieval Céline , Degasne Isabelle , Traversier Nicolas , Briere-Bellier Claire , Lutz Patrick , Uettwiller Françoise , Herbrecht Raoul , Letscher-Bru Valérie , Catherinot Emilie , Couderc Louis-Jean , Rivaud Elizabeth , Cahen Pierre , Bissuel François , Alvarez Muriel , Martin-Blondel Guillaume , Mourguet Morgane , Mouchon Emmanuelle , Huynh Anne , Gadaud Noémie , Guitard Joelle , Iriart Xavier , Cassaing Sophie , Joubert Christophe , Janvier Frédéric , Berric Audrey , Grill Jacques , Pasquier Florence , De Botton Stéphane , Chachaty Elisabeth ,   Characterization of the isolates at the NRCMA, Boullié Anne , Gautier Cécile , Hessel Audrey , Hoinard Damien , Raoux-Barbot Dorothée 
Published: September 2020

Abstract
Scedosporiosis/lomentosporiosis is a devastating emerging fungal infection. Our objective was to describe the clinical pattern and to analyze whether taxonomic grouping of the species involved was supported by differences in terms of clinical presentations or outcomes. We retrospectively studied cases of invasive scedosporiosis in France from 2005 through 2017 based on isolates characterized by polyphasic approach. We recorded 90 cases, mainly related to Scedosporium apiospermum (n = 48), S. boydii/S. ellipsoideum (n = 20), and Lomentospora prolificans (n = 14). One-third of infections were disseminated, with unexpectedly high rates of cerebral (41%) and cardiovascular (31%) involvement. In light of recent Scedosporium taxonomic revisions, we aimed to study the clinical significance of Scedosporium species identification and report for the first time contrasting clinical presentations between infections caused S. apiospermum, which were associated with malignancies and cutaneous involvement in disseminated infections, and infections caused by S. boydii, which were associated with solid organ transplantation, cerebral infections, fungemia, and early death. The clinical presentation of L. prolificans also differed from that of other species, involving more neutropenic patients, breakthrough infections, fungemia, and disseminated infections. Neutropenia, dissemination, and lack of antifungal prescription were all associated with 3-month mortality. Our data support the distinction between S. apiospermum and S. boydii and between L. prolificans and Scedosporium sp. Our results also underline the importance of the workup to assess dissemination, including cardiovascular system and brain.