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. 2025 Mar 17;80(3):529-539.
doi: 10.1093/cid/ciae594.

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

Thiziri Tala-Ighil  1 , Dea Garcia-Hermoso  2 , Frédéric Dalle  3 , Sophie Cassaing  4 , Juliette Guitard  5 , Karine Boukris-Sitbon  2 , Thomas Obadia  2 , Olivier Lortholary  1   2 , Valérie Letscher-Bru  6   7 , Marie-Pierre Ledoux  8 , Taïeb Chouaki  9 , Anne Pauline Bellanger  10 , Célia Rouges  11 , Marie Elisabeth Bougnoux  12 , Maxime Moniot  13 , Marc Pihet  14 , Vincent Dubée  15 , Frédéric Gabriel  16 , Florent Morio  17   18 , Lilia Hasseine  19 , Christine Bonnal  20 , Maud Gits-Muselli  21 , Estelle Perraud-Cateau  22 , Caroline Mahinc  23 , Muriel Nicolas  24 , Elisabeth Chachaty  25 , Camille Cordier  26 , Laurence Lachaud  27 , Laura Courtellemont  28 , Benoït Henry  29 , Cécile Angebault  30 , Gilles Gargala  31 , Adélaïde Chesnay  32 , Marie Liesse Pacreau  33 , Laure Kamus  34 , Nicole Desbois-Nogard  35 , Magalie Demar  36 , Loïc Epelboin  37 , Alexandre Alanio  2   38 , Eric Dannaoui  2   12 , Fanny Lanternier  1   2 ; French Mycoses Study Group
Collaborators, Affiliations

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

Thiziri Tala-Ighil et al. Clin Infect Dis. .

Abstract

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.

Keywords: Fusarium spp; L. prolificans; fungemia; hematological malignancy; mold.

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Conflict of interest statement

Potential conflicts of interest . F. D. has received funding from Pfizer for attending scientific events. S. C. has received funding from Gilead and Pfizer for attending scientific events. M.-P. L. has received funding from Gilead, AbbVie, Jazz, Grifols, and Servier for attending scientific events; has received payment from Gilead, Pfizer, Takeda, Servier, and Janssen for lectures; and has participated in advisory boards for AbbVie and Jazz. A. P. B. and C. B. have received funding from Gilead for attending scientific events. V. D. has served as expert witness for Pfizer SAS and Patientys. M. G. M. has received funding from the European Society of Clinical Microbiology and Infectious Diseases for scientific events and payment from Gilead for expert lectures. C. C. has served as unpaid speaker with Gilead. C. A. has received funding for attending scientific events by Gilead and from Pfizer for lectures. A. A. has received payment from Pfizer for educational lectures. E. D. has received funding from Gilead and Mundipharma for attending scientic events, and payment for Mundipharma and bioMérieux for expert lectures. F. L. has served on the speakers bureau and an advisory board for F2G. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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