Current Epidemiology and Infection Characteristics of Non-Aspergillus Mold Infections: A Multicenter Study in Australia and New Zealand

Neoh, CF; Chen, SCA; Australian and New Zealand Study Group for non-Aspergillus mold infections; Morris, AJ; Heath, CH; Tan, SJ; Lane, R; Tio, SY; Tay, SY; Roberts, MB; Kennedy, K; van Hal, SJ; Murray, HC; Pickles, R; Vaselli, NM; Douglas, A; Urbancic, K; Menon, M; Stewart, A; Howard, JC; Keighley, C; Miyakis, S; Beresford, R; Cooley, L; Sehu, M; Halliday, CL; Kidd, S; Kong, DCM; Spelman, T; Worth, LJ; Slavin, MA

Author(s): Neoh, CF; Chen, SCA; Australian and New Zealand Study Group for non-Aspergillus mold infections; Morris, AJ; Heath, CH; Tan, SJ; Lane, R; Tio, SY; Tay, SY; Roberts, MB; Kennedy, K; van Hal, SJ; Murray, HC; Pickles, R; Vaselli, NM; Douglas, A; Urbancic, K; Menon, M; Stewart, A; Howard, JC; Keighley, C; Miyakis, S; Beresford, R; Cooley, L; Sehu, M; Halliday, CL; Kidd, S; Kong, DCM; Spelman, T; Worth, LJ; Slavin, MA;
Details: Publication Year 2026-07-23,Volume 83,Issue #1,Page 120-130
Journal Title: Clinical Infectious Diseases
Publication Type: Research article
Abstract: BACKGROUND: Understanding the epidemiology of invasive non-Aspergillus mold infections is essential to inform effective therapy. This study aimed to determine the epidemiology and infection characteristics of non-Aspergillus mold infections in Australasia. METHODS: A 21-center, retrospective study of proven/probable non-Aspergillus mold infections from 2016 to 2023 was conducted in Australia and New Zealand. Data collected included demographic, clinical, microbiological, treatment, and outcome information through 180 days of follow-up. RESULTS: Of 421 cases, 346 (82.2%) were proven infections and 315 (74.8%) were localized. Lung (n = 150, 35.6%) was the most common site of infection. Twenty cases (4.8%) were due to >1 non-Aspergillus mold pathogen, resulting in 443 isolates in total. Dematiaceous molds, inclusive of Lomentospora prolificans (n = 96 of 443, 21.7%), Scedosporium spp. (n = 87 of 443, 19.6%), and other dematiaceous molds of various genera (n = 48 of 443, 10.8%), were the most common (n = 231 of 443, 52.1%), followed by Mucorales (n = 141 of 443, 31.8%). Common underlying conditions were hematological malignancy (n = 146, 34.7%) and diabetes mellitus (n = 122, 29.0%), while 68 cases (16.2%) had no comorbidities. One-third (n = 138, 32.8%) of patients received antifungal prophylaxis 30 days before non-Aspergillus mold diagnosis, and L. prolificans was the most common cause of breakthrough infections (P < .001). All-cause 90-day mortality was 31.4% (n = 132 of 421), with higher mortality observed in L. prolificans (n = 51 of 89, 57.3%) and Mucorales (n = 56 of 129, 43.4%) infections. CONCLUSIONS: Lomentospora prolificans, Scedosporium spp., and Mucorales are the most frequent non-Aspergillus mold pathogens in Australasia, with other emerging species and mixed infections encountered. Mortality from L. prolificans and Mucorales infections remains high.
Publisher: Oxford University Press
Keywords: Humans; New Zealand/epidemiology; Australia/epidemiology; Retrospective Studies; Female; Male; *Fungi/classification/isolation & purification; Middle Aged; Antifungal Agents/therapeutic use; Adult; *Mycoses/epidemiology/microbiology/drug therapy; Aged; Adolescent; *Invasive Fungal Infections/epidemiology/microbiology; Young Adult; Child; Child, Preschool; epidemiology; non-Aspergillus mold; rare mold infections
Department(s): Infectious Diseases; Health Services Research
Publisher's Version: https://doi.org/10.1093/cid/ciag029
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-02-03 03:57:05

Last Modified: 2026-08-11 05:52:49