P279 Invasive Trichosporonosis: an emerging blood stream fungal infection in immunocompromised patients

POSTER SESSION 2, SEPTEMBER 22, 2022, 12:30 PM - 1:30 PM: Trichosporon is a genus of yeast-like fungi. It is perhaps most widely known as the cause of white piedra, a benign superficial mycosis seen in immunocompetent individuals in tropical and subtropical regions. However, the incidence of invasive trichosporonosis has increased in immunocompromised patients, most notably those with hematologic malignancies. Invasive infections due to Trichosporon species are considered rare so far, but during the past two decades, they have emerged as important opportunistic pathogens in immunocompromised individuals. : All patients with blood culture positive for Trichosporon species from January 2020 to August 2020 at Woodlands Multispecialty Hospital, Kolkata, India were evaluated. In vitro susceptibility testing was performed using the reference broth micro-dilution method. Clinical co-relation was done with the positive culture report and patient's clinical condition to rule out colonization/contamination. : A total of 7 patients were found to have blood culture positive for Trichosporon species among which five were true infections. Various predisposing factors previously reported to be associated with invasive trichosporonosis were also considered in the present study. All the cases were associated with either post radiotherapy/chemotherapy with renal failure requiring dialysis via hemodialysis catheter or use of central venous catheter or chemoport. Underlying malignancy was found in all patients. Susceptibility testing has been performed for 5-FC, amphotericin B, and Azoles. Azoles had good in vitro activity, whereas amphotericin B had higher MIC values. The all-cause mortality rate was 43%. : Invasive Trichosporon infection is a rare, life-threatening infection in immunocompromised patients. Our study highlights the association of central venous catheter and hemodialysis catheter with Trichosporon fungemia and its high mortality. Therefore, strict infection control measures while handling these devices are recommended to prevent these infections. Species identification and susceptibility testing are to be attempted for all relevant clinical isolates in view of demonstrable resistance to certain antifungal drugs. Echinocandins are not effective in the treatment of trichosporon infection. Amphotericin B should also be avoided. Azoles, in particular, voriconazole is the drug of choice.