Current Epidemiology and Infection Characteristics of Non-Aspergillus Mold Infections: A Multicenter Study in Australia and New Zealand
- Author(s)
- Neoh, CF; Chen, SC; 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; Australian and New Zealand Study Group for non-Aspergillus mold infections;
- Journal Title
- Clinical Infectious Diseases
- Publication Type
- Online publication before print
- Abstract
- BACKGROUND: Understanding the epidemiology of invasive non-Aspergillus mold infections is essential to inform effective therapy. Robust regional studies remain scarce. 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 until 180 days of follow-up. RESULTS: Of 421 cases, 346 (82.2%) were proven infections and 315 (74.8%) were localized. Lung (n=150/421, 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 altogether. Dematiaceous molds, inclusive of Lomentospora prolificans (n=96, 21.7%), Scedosporium spp. (n=87, 19.6%) and other dematiaceous molds of various genera (n=48, 10.8%), were the most common (n=231, 52.1%), followed by Mucorales (n=141, 31.8%). Common underlying conditions were hematological malignancy (n=146/421, 34.7%) and diabetes mellitus (n=122/421, 29.0%) while 68 cases (16.2%) had no comorbidities. Lymphopenia was present in 46.6% (n=196/421). One-third (n=138/421, 32.8%) received antifungal prophylaxis 30 days before non-Aspergillus mold diagnosis and L. prolificans was the most common cause of breakthrough infections (p<0.001). All-cause 90-day mortality was 31.4% (n=132/421), with higher mortality observed in L. prolificans (n=51/89, 57.3%) and Mucorales (n=56/129, 43.4%) infections. CONCLUSIONS: L. 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.
- Keywords
- 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: 2026-02-03 03:57:13