Invasive fungal infections

Key clinical point: Antibiotic resistance increased with longer hospital stays; vancomycin resistance increased among enterococci, and ceftriaxone and carbapenem resistance among Enterobacterales.

Major finding: A total of 183 community-associated coinfections were identified in COVID-19 patients who met criteria for infection (6%); hospital-acquired infections occurred in 350 patients (12%). Of the hospital-acquired infections, 57% were caused by gram-negative bacteria and 19% were caused by fungi.  

Study details: The data come from 3,028 adults with COVID-19 diagnosed between March 2, 2020, and May 31, 2020, who were hospitalized for at least 24 hours; 516 patients of 899 with positive cultures met criteria for infection.

Disclosures: The study was supported by the National Institute of Allergy and Infectious Diseases, National Institutes of Health, and the Centers for Disease Control and Prevention. The researchers had no financial conflicts to disclose.

Source: Kubin CJ et al. Open Forum Infect Dis. 2021 May 5. doi: 10.1093/ofid/ofab201.

Key clinical point: Antibiotic resistance increased with longer hospital stays; vancomycin resistance increased among enterococci, and ceftriaxone and carbapenem resistance among Enterobacterales.

Major finding: A total of 183 community-associated coinfections were identified in COVID-19 patients who met criteria for infection (6%); hospital-acquired infections occurred in 350 patients (12%). Of the hospital-acquired infections, 57% were caused by gram-negative bacteria and 19% were caused by fungi.  

Study details: The data come from 3,028 adults with COVID-19 diagnosed between March 2, 2020, and May 31, 2020, who were hospitalized for at least 24 hours; 516 patients of 899 with positive cultures met criteria for infection.

Disclosures: The study was supported by the National Institute of Allergy and Infectious Diseases, National Institutes of Health, and the Centers for Disease Control and Prevention. The researchers had no financial conflicts to disclose.

Source: Kubin CJ et al. Open Forum Infect Dis. 2021 May 5. doi: 10.1093/ofid/ofab201.

Key clinical point: Antibiotic resistance increased with longer hospital stays; vancomycin resistance increased among enterococci, and ceftriaxone and carbapenem resistance among Enterobacterales.

Major finding: A total of 183 community-associated coinfections were identified in COVID-19 patients who met criteria for infection (6%); hospital-acquired infections occurred in 350 patients (12%). Of the hospital-acquired infections, 57% were caused by gram-negative bacteria and 19% were caused by fungi.  

Study details: The data come from 3,028 adults with COVID-19 diagnosed between March 2, 2020, and May 31, 2020, who were hospitalized for at least 24 hours; 516 patients of 899 with positive cultures met criteria for infection.

Disclosures: The study was supported by the National Institute of Allergy and Infectious Diseases, National Institutes of Health, and the Centers for Disease Control and Prevention. The researchers had no financial conflicts to disclose.

Source: Kubin CJ et al. Open Forum Infect Dis. 2021 May 5. doi: 10.1093/ofid/ofab201.

Key clinical point: More than half of hospitalized COVID-19 patients developed at least one superinfection, including 75 cases of ventilator-associated pneumonia and 57 systemic infections. Overall, bacterial infections, age, and the highest Sequential Organ Failure Assessment score were independently associated with ICU mortality or 28-day mortality.

Major finding: The most common pathogens behind cases of ventilator-associated pneumonia were Pseudomonas aeruginosa (34.7%) and Stenotrophomonas maltophilia (18.7%). Bloodstream infections occurred in 16 cases, and fungal infections occurred in 41 cases.

Study details: The data come from a retrospective analysis of prospectively collected data from 92 adults with COVID-19 who were admitted to a single ICU between February 21, 2020, and May 6, 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Signorini L et al. Crit Care Explor. 2021 Jun 11. doi: 10.1097/CCE.0000000000000430.

Key clinical point: More than half of hospitalized COVID-19 patients developed at least one superinfection, including 75 cases of ventilator-associated pneumonia and 57 systemic infections. Overall, bacterial infections, age, and the highest Sequential Organ Failure Assessment score were independently associated with ICU mortality or 28-day mortality.

Major finding: The most common pathogens behind cases of ventilator-associated pneumonia were Pseudomonas aeruginosa (34.7%) and Stenotrophomonas maltophilia (18.7%). Bloodstream infections occurred in 16 cases, and fungal infections occurred in 41 cases.

Study details: The data come from a retrospective analysis of prospectively collected data from 92 adults with COVID-19 who were admitted to a single ICU between February 21, 2020, and May 6, 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Signorini L et al. Crit Care Explor. 2021 Jun 11. doi: 10.1097/CCE.0000000000000430.

Key clinical point: More than half of hospitalized COVID-19 patients developed at least one superinfection, including 75 cases of ventilator-associated pneumonia and 57 systemic infections. Overall, bacterial infections, age, and the highest Sequential Organ Failure Assessment score were independently associated with ICU mortality or 28-day mortality.

Major finding: The most common pathogens behind cases of ventilator-associated pneumonia were Pseudomonas aeruginosa (34.7%) and Stenotrophomonas maltophilia (18.7%). Bloodstream infections occurred in 16 cases, and fungal infections occurred in 41 cases.

Study details: The data come from a retrospective analysis of prospectively collected data from 92 adults with COVID-19 who were admitted to a single ICU between February 21, 2020, and May 6, 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Signorini L et al. Crit Care Explor. 2021 Jun 11. doi: 10.1097/CCE.0000000000000430.

Key clinical point: Candida albicans showed the strongest exoenzyme activity compared to non-albicans isolates in oral cavity samples from adults with diabetes.

Major finding:  Candida albicans isolates showed 97.3%, 100%, and 77.3% exoenzyme activity for phospholipase, hemolysin, and esterase, respectively. Differences in activity between albicans and non-albicans isolates were significant for phospholipase and hemolysin, but did not reach significance for esterase.

Study details: The data come from 108 Candida species including 75 Candida albicans and 33 non-albicans taken from diabetes patients’ oral cavity samples.

Disclosures: The study was supported by the Deputy of Research and Technology of Shiraz University of Medical Sciences, Shiraz, Iran. The study was part of the MD thesis of coauthor Mehdi Ghaderian Jahromi. The researchers had no financial conflicts to disclose.

Source: Nouraei H et al. Biomed Res Int. 2021 May 26. doi: 10.1155/2021/9982744.

Key clinical point: Candida albicans showed the strongest exoenzyme activity compared to non-albicans isolates in oral cavity samples from adults with diabetes.

Major finding:  Candida albicans isolates showed 97.3%, 100%, and 77.3% exoenzyme activity for phospholipase, hemolysin, and esterase, respectively. Differences in activity between albicans and non-albicans isolates were significant for phospholipase and hemolysin, but did not reach significance for esterase.

Study details: The data come from 108 Candida species including 75 Candida albicans and 33 non-albicans taken from diabetes patients’ oral cavity samples.

Disclosures: The study was supported by the Deputy of Research and Technology of Shiraz University of Medical Sciences, Shiraz, Iran. The study was part of the MD thesis of coauthor Mehdi Ghaderian Jahromi. The researchers had no financial conflicts to disclose.

Source: Nouraei H et al. Biomed Res Int. 2021 May 26. doi: 10.1155/2021/9982744.

Key clinical point: Candida albicans showed the strongest exoenzyme activity compared to non-albicans isolates in oral cavity samples from adults with diabetes.

Major finding:  Candida albicans isolates showed 97.3%, 100%, and 77.3% exoenzyme activity for phospholipase, hemolysin, and esterase, respectively. Differences in activity between albicans and non-albicans isolates were significant for phospholipase and hemolysin, but did not reach significance for esterase.

Study details: The data come from 108 Candida species including 75 Candida albicans and 33 non-albicans taken from diabetes patients’ oral cavity samples.

Disclosures: The study was supported by the Deputy of Research and Technology of Shiraz University of Medical Sciences, Shiraz, Iran. The study was part of the MD thesis of coauthor Mehdi Ghaderian Jahromi. The researchers had no financial conflicts to disclose.

Source: Nouraei H et al. Biomed Res Int. 2021 May 26. doi: 10.1155/2021/9982744.

Key clinical point: Fungal or bacterial bloodstream infections were common in children within 5 years of liver or kidney transplants; the overall incidence in the first year post-transplant was 1.91 per 100 recipients per month.

Major finding:  A total of 29 of 85 children who underwent liver or kidney transplants developed bacterial or fungal bloodstream infections within 5 years of their transplants with 16 different pathogens; the most common were Enterococcus faecium, Candida albicans, Escherichia coli, and Klebsiella pneumoniae.

Study details: The data come from a prospective study of 85 pediatric patients who underwent liver and kidney transplants between 2010 and 2017; the total follow-up was 390 person-years.

Disclosures: The study was supported by the Novo Nordic Foundation, the Independent Research Fund (FSS), the Danish National Research Foundation (DNRF), and the Research Foundation of Rigshospitalet; several coauthors also disclosed support from these organizations, as well as from Gilead and Merck.

Source: Møller DL et al. BMC Infect Dis. 2021 Jun 8. doi: 10.1186/s12879-021-06224-2.

Key clinical point: Fungal or bacterial bloodstream infections were common in children within 5 years of liver or kidney transplants; the overall incidence in the first year post-transplant was 1.91 per 100 recipients per month.

Major finding:  A total of 29 of 85 children who underwent liver or kidney transplants developed bacterial or fungal bloodstream infections within 5 years of their transplants with 16 different pathogens; the most common were Enterococcus faecium, Candida albicans, Escherichia coli, and Klebsiella pneumoniae.

Study details: The data come from a prospective study of 85 pediatric patients who underwent liver and kidney transplants between 2010 and 2017; the total follow-up was 390 person-years.

Disclosures: The study was supported by the Novo Nordic Foundation, the Independent Research Fund (FSS), the Danish National Research Foundation (DNRF), and the Research Foundation of Rigshospitalet; several coauthors also disclosed support from these organizations, as well as from Gilead and Merck.

Source: Møller DL et al. BMC Infect Dis. 2021 Jun 8. doi: 10.1186/s12879-021-06224-2.

Key clinical point: Fungal or bacterial bloodstream infections were common in children within 5 years of liver or kidney transplants; the overall incidence in the first year post-transplant was 1.91 per 100 recipients per month.

Major finding:  A total of 29 of 85 children who underwent liver or kidney transplants developed bacterial or fungal bloodstream infections within 5 years of their transplants with 16 different pathogens; the most common were Enterococcus faecium, Candida albicans, Escherichia coli, and Klebsiella pneumoniae.

Study details: The data come from a prospective study of 85 pediatric patients who underwent liver and kidney transplants between 2010 and 2017; the total follow-up was 390 person-years.

Disclosures: The study was supported by the Novo Nordic Foundation, the Independent Research Fund (FSS), the Danish National Research Foundation (DNRF), and the Research Foundation of Rigshospitalet; several coauthors also disclosed support from these organizations, as well as from Gilead and Merck.

Source: Møller DL et al. BMC Infect Dis. 2021 Jun 8. doi: 10.1186/s12879-021-06224-2.

Key clinical point: Mucormycosis cases surged after the appearance of COVID-19, but adjunct surgery in COVID-19 patients with mucormycosis improved clinical outcomes.

Major finding:  The mortality rate among 99 COVID-19 patients with mucormycosis was 34%. However, 81% of the patients underwent adjunct surgery, which significantly improved outcomes (P < 0.001).

Study details: The data come from 30 case series and case reports totaling 99 patients with COVID-19-associated mucormycosis (CAM). Glucocorticoids, a known risk factor for CAM, were used in 85% of the patients, and the average time from COVID-19 diagnosis to CAM diagnosis was 15 days.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Pal R et al. Mycoses. 2021 Jun 16. doi: 10.1111/myc.13338.

Key clinical point: Mucormycosis cases surged after the appearance of COVID-19, but adjunct surgery in COVID-19 patients with mucormycosis improved clinical outcomes.

Major finding:  The mortality rate among 99 COVID-19 patients with mucormycosis was 34%. However, 81% of the patients underwent adjunct surgery, which significantly improved outcomes (P < 0.001).

Study details: The data come from 30 case series and case reports totaling 99 patients with COVID-19-associated mucormycosis (CAM). Glucocorticoids, a known risk factor for CAM, were used in 85% of the patients, and the average time from COVID-19 diagnosis to CAM diagnosis was 15 days.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Pal R et al. Mycoses. 2021 Jun 16. doi: 10.1111/myc.13338.

Key clinical point: Mucormycosis cases surged after the appearance of COVID-19, but adjunct surgery in COVID-19 patients with mucormycosis improved clinical outcomes.

Major finding:  The mortality rate among 99 COVID-19 patients with mucormycosis was 34%. However, 81% of the patients underwent adjunct surgery, which significantly improved outcomes (P < 0.001).

Study details: The data come from 30 case series and case reports totaling 99 patients with COVID-19-associated mucormycosis (CAM). Glucocorticoids, a known risk factor for CAM, were used in 85% of the patients, and the average time from COVID-19 diagnosis to CAM diagnosis was 15 days.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Pal R et al. Mycoses. 2021 Jun 16. doi: 10.1111/myc.13338.

Key clinical point: The small number of invasive aspergillosis cases may contribute to the low specificity of several tests in children after stem cell transplants and should be interpreted with caution.

Major finding: The sensitivity and specificity for probable invasive aspergillosis and potential invasive fungal disease was 80% and 55% for (1→3)-β-D-glucan (BDG); 40% and 100% for galactomannan; and 60% (and 95% (95% CI: 75–100%) for Aspergillus-specific real-time PCR.

Study details: The data come from 404 blood samples taken from 26 pediatric patients who underwent allogeneic hematopoietic stem cell transplantation between April 2016 and March 2018 at a single center.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Springer J et al. J Fungi (Basel). 2021 Mar 22. doi: 10.3390/jof7030238.

Key clinical point: The small number of invasive aspergillosis cases may contribute to the low specificity of several tests in children after stem cell transplants and should be interpreted with caution.

Major finding: The sensitivity and specificity for probable invasive aspergillosis and potential invasive fungal disease was 80% and 55% for (1→3)-β-D-glucan (BDG); 40% and 100% for galactomannan; and 60% (and 95% (95% CI: 75–100%) for Aspergillus-specific real-time PCR.

Study details: The data come from 404 blood samples taken from 26 pediatric patients who underwent allogeneic hematopoietic stem cell transplantation between April 2016 and March 2018 at a single center.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Springer J et al. J Fungi (Basel). 2021 Mar 22. doi: 10.3390/jof7030238.

Key clinical point: The small number of invasive aspergillosis cases may contribute to the low specificity of several tests in children after stem cell transplants and should be interpreted with caution.

Major finding: The sensitivity and specificity for probable invasive aspergillosis and potential invasive fungal disease was 80% and 55% for (1→3)-β-D-glucan (BDG); 40% and 100% for galactomannan; and 60% (and 95% (95% CI: 75–100%) for Aspergillus-specific real-time PCR.

Study details: The data come from 404 blood samples taken from 26 pediatric patients who underwent allogeneic hematopoietic stem cell transplantation between April 2016 and March 2018 at a single center.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Springer J et al. J Fungi (Basel). 2021 Mar 22. doi: 10.3390/jof7030238.

Key clinical point: Patients with severe COVID-19 and secondary coinfections had higher mortality rates and longer hospital stays compared to patients without secondary infections.

Major finding: The overall mortality rate was approximately 50%, but 83.14% of the patients with fungal or bacterial isolation died. The risk of death was significantly higher in patients with bacterial and fungal coinfections (odds ratios 11.28 and 5.97, respectively).

Study details: The data come from an analysis of 212 severely ill patients with COVID-19; 89 of these had fungal or bacterial secondary coinfections.

Disclosures: The study was supported by the Fundação de Amparo a Pesquisa do Estado de Minas Gerais - FAPEMIG and the Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq and Brazilian Ministry of Health. The researchers had no financial conflicts to disclose.

Source: Silva DL et al. J Hosp Infect. 2021 Apr 11. doi: 10.1016/j.jhin.2021.04.001.

Key clinical point: Patients with severe COVID-19 and secondary coinfections had higher mortality rates and longer hospital stays compared to patients without secondary infections.

Major finding: The overall mortality rate was approximately 50%, but 83.14% of the patients with fungal or bacterial isolation died. The risk of death was significantly higher in patients with bacterial and fungal coinfections (odds ratios 11.28 and 5.97, respectively).

Study details: The data come from an analysis of 212 severely ill patients with COVID-19; 89 of these had fungal or bacterial secondary coinfections.

Disclosures: The study was supported by the Fundação de Amparo a Pesquisa do Estado de Minas Gerais - FAPEMIG and the Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq and Brazilian Ministry of Health. The researchers had no financial conflicts to disclose.

Source: Silva DL et al. J Hosp Infect. 2021 Apr 11. doi: 10.1016/j.jhin.2021.04.001.

Key clinical point: Patients with severe COVID-19 and secondary coinfections had higher mortality rates and longer hospital stays compared to patients without secondary infections.

Major finding: The overall mortality rate was approximately 50%, but 83.14% of the patients with fungal or bacterial isolation died. The risk of death was significantly higher in patients with bacterial and fungal coinfections (odds ratios 11.28 and 5.97, respectively).

Study details: The data come from an analysis of 212 severely ill patients with COVID-19; 89 of these had fungal or bacterial secondary coinfections.

Disclosures: The study was supported by the Fundação de Amparo a Pesquisa do Estado de Minas Gerais - FAPEMIG and the Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq and Brazilian Ministry of Health. The researchers had no financial conflicts to disclose.

Source: Silva DL et al. J Hosp Infect. 2021 Apr 11. doi: 10.1016/j.jhin.2021.04.001.

Key clinical point: Triazole antifungal agents, as well as amphotericin B and caspofungin, reduced rates of invasive fungal infections in patients with hematological malginancies; notably, posaconazole also was more effective at reducing all-cause mortality and adverse events compared with other triazoles.

Major finding: Posaconazole was superior to fluconazole (odds ratio 0.30), itraconazole (OR 0.40), and amphotericin B (OR 4.97) in reducing the incidence of both suspected and confirmed invasive fungal infections.

Study details: The data come from a meta-analysis of 35 studies including 37 randomized, controlled trials of the effectiveness of triazoles, polyene, and echinocandin antifungals for infection control in patients with hematological malignancies.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Zeng H et al. BMC Cancer. 2021 Apr 14. doi: 10.1186/s12885-021-07973-8.

Key clinical point: Triazole antifungal agents, as well as amphotericin B and caspofungin, reduced rates of invasive fungal infections in patients with hematological malginancies; notably, posaconazole also was more effective at reducing all-cause mortality and adverse events compared with other triazoles.

Major finding: Posaconazole was superior to fluconazole (odds ratio 0.30), itraconazole (OR 0.40), and amphotericin B (OR 4.97) in reducing the incidence of both suspected and confirmed invasive fungal infections.

Study details: The data come from a meta-analysis of 35 studies including 37 randomized, controlled trials of the effectiveness of triazoles, polyene, and echinocandin antifungals for infection control in patients with hematological malignancies.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Zeng H et al. BMC Cancer. 2021 Apr 14. doi: 10.1186/s12885-021-07973-8.

Key clinical point: Triazole antifungal agents, as well as amphotericin B and caspofungin, reduced rates of invasive fungal infections in patients with hematological malginancies; notably, posaconazole also was more effective at reducing all-cause mortality and adverse events compared with other triazoles.

Major finding: Posaconazole was superior to fluconazole (odds ratio 0.30), itraconazole (OR 0.40), and amphotericin B (OR 4.97) in reducing the incidence of both suspected and confirmed invasive fungal infections.

Study details: The data come from a meta-analysis of 35 studies including 37 randomized, controlled trials of the effectiveness of triazoles, polyene, and echinocandin antifungals for infection control in patients with hematological malignancies.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Zeng H et al. BMC Cancer. 2021 Apr 14. doi: 10.1186/s12885-021-07973-8.

Key clinical point: Concentrations of echinocandin penetration into wound secretions may be sub-therapeutic in some patients, and the relevance to clinical outcomes in patients with severe invasive candidiasis infections remains unclear.

Major finding: Concentrations of echinocandins in wound secretions were significantly lower than simultaneous plasma concentrations, and measured less than 0.025 mg/L-2.25 mg/L for anidulafungin; 0.025 mg/L-2.53 mg/L for micafungin; and 0.18 mg/L-4.04 mg/L for caspofungin.

Study details: The data come from 21 critically ill adults with suspected or confirmed invasive fungal infections who were treated with an echinocandins anidulafungin (AFG), micafungin (MFG), and caspofungin (CAS); concentrations in wound secretion were measured using liquid chromatography or tandem mass spectrometry detection.

Disclosures: The study was supported by the University of Innsbruck and Medical University of Innsbruck, and by the Austrian Science Fund. The researchers had no financial conflicts to disclose.

Source: Gasperetti T et al. Infection. 2021 Apr 20. doi: 10.1007/s15010-021-01604-x.

Key clinical point: Concentrations of echinocandin penetration into wound secretions may be sub-therapeutic in some patients, and the relevance to clinical outcomes in patients with severe invasive candidiasis infections remains unclear.

Major finding: Concentrations of echinocandins in wound secretions were significantly lower than simultaneous plasma concentrations, and measured less than 0.025 mg/L-2.25 mg/L for anidulafungin; 0.025 mg/L-2.53 mg/L for micafungin; and 0.18 mg/L-4.04 mg/L for caspofungin.

Study details: The data come from 21 critically ill adults with suspected or confirmed invasive fungal infections who were treated with an echinocandins anidulafungin (AFG), micafungin (MFG), and caspofungin (CAS); concentrations in wound secretion were measured using liquid chromatography or tandem mass spectrometry detection.

Disclosures: The study was supported by the University of Innsbruck and Medical University of Innsbruck, and by the Austrian Science Fund. The researchers had no financial conflicts to disclose.

Source: Gasperetti T et al. Infection. 2021 Apr 20. doi: 10.1007/s15010-021-01604-x.

Key clinical point: Concentrations of echinocandin penetration into wound secretions may be sub-therapeutic in some patients, and the relevance to clinical outcomes in patients with severe invasive candidiasis infections remains unclear.

Major finding: Concentrations of echinocandins in wound secretions were significantly lower than simultaneous plasma concentrations, and measured less than 0.025 mg/L-2.25 mg/L for anidulafungin; 0.025 mg/L-2.53 mg/L for micafungin; and 0.18 mg/L-4.04 mg/L for caspofungin.

Study details: The data come from 21 critically ill adults with suspected or confirmed invasive fungal infections who were treated with an echinocandins anidulafungin (AFG), micafungin (MFG), and caspofungin (CAS); concentrations in wound secretion were measured using liquid chromatography or tandem mass spectrometry detection.

Disclosures: The study was supported by the University of Innsbruck and Medical University of Innsbruck, and by the Austrian Science Fund. The researchers had no financial conflicts to disclose.

Source: Gasperetti T et al. Infection. 2021 Apr 20. doi: 10.1007/s15010-021-01604-x.

Key clinical point: Invasive fungal infections, though rare, have been observed in multiple sclerosis patients using a range of disease-modifying treatments and should be suspected in patients presenting with signs of infection.

Major finding:  The overall occurrence of invasive fungal infections in patients with multiple sclerosis on disease-modifying treatments was low, but monoclonal antibodies were associated with higher rates of infection. The most common infection sources were Aspergillosis and cryptococcal meningitidis.

Study details: The data come from a meta-analysis of patients treated with rituximab, ocrelizumab, alemtuzumab, fingolimod, natalizumab, dimethyl fumarate, interferon, glatiramer acetate, cladribine, teriflunomide.

Disclosures: The study received no outside funding. Lead author Dr. Scotto had no financial conflicts to disclose; several coauthors disclosed relationships with companies including Almirall, Bayer, Biogen, Merck, Novartis, Roche, and Sanofi-Genzyme.

Source: Scotto R et al.  Expert Opin Drug Saf. 2021 Apr 21. doi: 10.1080/14740338.2021.1918673.

Key clinical point: Invasive fungal infections, though rare, have been observed in multiple sclerosis patients using a range of disease-modifying treatments and should be suspected in patients presenting with signs of infection.

Major finding:  The overall occurrence of invasive fungal infections in patients with multiple sclerosis on disease-modifying treatments was low, but monoclonal antibodies were associated with higher rates of infection. The most common infection sources were Aspergillosis and cryptococcal meningitidis.

Study details: The data come from a meta-analysis of patients treated with rituximab, ocrelizumab, alemtuzumab, fingolimod, natalizumab, dimethyl fumarate, interferon, glatiramer acetate, cladribine, teriflunomide.

Disclosures: The study received no outside funding. Lead author Dr. Scotto had no financial conflicts to disclose; several coauthors disclosed relationships with companies including Almirall, Bayer, Biogen, Merck, Novartis, Roche, and Sanofi-Genzyme.

Source: Scotto R et al.  Expert Opin Drug Saf. 2021 Apr 21. doi: 10.1080/14740338.2021.1918673.

Key clinical point: Invasive fungal infections, though rare, have been observed in multiple sclerosis patients using a range of disease-modifying treatments and should be suspected in patients presenting with signs of infection.

Major finding:  The overall occurrence of invasive fungal infections in patients with multiple sclerosis on disease-modifying treatments was low, but monoclonal antibodies were associated with higher rates of infection. The most common infection sources were Aspergillosis and cryptococcal meningitidis.

Study details: The data come from a meta-analysis of patients treated with rituximab, ocrelizumab, alemtuzumab, fingolimod, natalizumab, dimethyl fumarate, interferon, glatiramer acetate, cladribine, teriflunomide.

Disclosures: The study received no outside funding. Lead author Dr. Scotto had no financial conflicts to disclose; several coauthors disclosed relationships with companies including Almirall, Bayer, Biogen, Merck, Novartis, Roche, and Sanofi-Genzyme.

Source: Scotto R et al.  Expert Opin Drug Saf. 2021 Apr 21. doi: 10.1080/14740338.2021.1918673.