FungiScope FungiThek FungiQuest
FungiScope™ – Global Emerging Fungal Infection Registry D.
Seidel1, K. Wahlers1, M.J.G.T. Vehreschild1, P. Köhler1, F.
Müller1, H. Wisplinghoff2, J.J. Vehreschild1, O.A. Cornely1,3 on
behalf of
The FungiScope ECMM/ISHAM Working Group
1 1st Department of Internal Medicine, University of Cologne,
Cologne, Germany, 2 Institute for Medical Microbiology, Immunology
and Hygiene, University of Cologne, Cologne, Germany, 3 Clinical
Trials Center Cologne, ZKS Köln, BMBF 01KN1106, University of
Cologne, Cologne, Germany
Background
The incidence of invasive fungal infections (IFI) is increasing
worldwide. While the etiology of this development has not been
completely understood, evermore invasive medical care as well as
increasing numbers of long-term immunocompromised patients are
considered major contributing factors.
A wide variety of so-called “emerging fungi” accounts for a
significant proportion of IFI. Data on their epidemiology, pathogen
biology and clinical course is scarce, often impeding
evidence-guided decision making in the clinical setting.
To overcome these difficulties and eventually improve patient
care, FungiScopeTM – Global Emerging Fungal Infection Registry has
been created in 2003.
Methods
Filing patient data in an online database
Epidemiological survey on the incidence of emerging fungal
infections
FungiThek: Biobanking and reference analysis of cultured
isolates and tissue samples,
as well as exchange with other centers for research projects
FungiQuest: A search engine of the FungiScope database
Therapeutic antifungal drug monitoring
Inclusion criteria: Cultural, histopathological, antigen or
molecular biologic
evidence of IFI
Exclusion criteria: Colonization or infections due to
Aspergillus spp., Candida spp.,
Cryptococcus neoformans, Pneumocystis jiroveci and any endemic
fungal infection
The registry is open to everybody wishing to contribute a case
of an emerging fungal infection
Conclusions
Increasing relevance of rare IFI
Efficient method: 379 cases of rare IFI from Europe, North and
South America, and Asia have been documented
Increasing annual case numbers
Goals
Publication of a comprehensive analysis on rare yeasts
Publication of a comparison between sequencing and
morphological results for the first 100 FungiThek isolates
Further improvement of the FungiQuest platform
Results
Mucormycotina (previously
Zygomycota) 164
Fusarium spp. 61
Yeast 51
Dematiaceae 43
Penicillium spp./ Paecilomyces spp.
17
Scedosporium spp. 14
Other 29
Figure 2: Annual case documentation is steadily increasing
Figure 3: Contributing countries The three top contributing
countries are Germany, India and the Czech Republic.
Figure 4: Distribution of Pathogens From January 2003 – July
2014, 379 cases have been documented and considered valid -
Mucor-mycotina are the most commonly registered pathogens followed
by Fusarium spp. and yeasts.
Contact Danila Seidel, MS, PhD University Hospital of Cologne
Center for Clinical Trials Cologne Herderstrasse 52-54 50931
Cologne Germany Phone +49 221 478 97343, Fax +49 221 478 89027
Email [email protected]
Figure 6: Risk factors and site of infection for the four most
common pathogens Chemotherapy is the most important risk factor for
most fungi except for Dematiaceae. The most common sites of
infection vary greatly between the different fungi. Only the more
common sites (> 10%) are shown. HSCT Hematopoietic Stem Cell
Transplantation, ICU Intensive Care Unit, CPD Chronic Pulmonary
Disease, CNS Central Nervous System, GI Gastrointestinal
Figure 1: Project overview
Mucorales (n = 164)
Fusarium spp. (n = 61)
Yeasts (n = 51)
Dematiaceae (n = 43)
Risk Factors Site of Infection
In cooperation with: A working group of:
17%
27%
31%
56%
Diabetes mellitus
ICU stay
HSCT
Chemotherapy
15%
21%
31%
61%
Diabetes mellitus
ICU stay
HSCT
Chemotherapy
10%
12%
14%
14%
16%
36%
51%
Major surgery
Solid organ transplant
CPD
Diabetes mellitus
HSCT
ICU stay
Chemotherapy
Figure 5: Outcome for the four most common pathogens Outcome is
poor for most infections with emerging fungi with the exception of
IFI due to Dematiaceae.
12%
14%
44%
Solid organ transplant
Chronic renal disease
Diabetes
Supported by unrestricted grants from Astellas Pharma, Gilead
Sciences, MSD/Merck, and Pfizer Pharma GmbH
Diagnosis of IFI with rare fungus
Centralization and storage of isolates
Diagnostics laboratories
www.fungiscope.net
Registration and Password Acquisition
[email protected]
Electronic Case Report Form
Macroscopic and microscopic
identification
ATCATTAGTGATTGCCTTTATAGGCTTATAACTATATCCACTTACACCTGTGAACTGTTCTACTACTTGACGCAAGTCGAGTATTTTTACAAACAATGTGTAATGAACGTCGTTTTATTATAACAAAATAAAACTTTCAACAACGGATCTCTTGGCTCTCGCATCGATGAAGAACGCAGCGAATTGCGATAAGTAATGTGAATTGCAGAATTCAGTGAATCATCGAATCTTTGAACGCAGCTTGCGCTCCTGGTATTCCGGAGAGCATGCCTGTTTCAGGACTACCCGCTGAACTTCGCATCGATGAAGAACGCAGCGAATTGCGATAAGTAATGTGAATTGCAGATGAG
Mass Spectrometry
Sequencing
Reference database Link specimens to clinical and
demographic data Manage requests for specimen use
www.fungiquest.net Search the database
Diagnosis of IFI with rare fungus
Browse through cases Diagnostics FungiThek Culture/Biopsy
Banking
FungiQuest Database
Search
Therapeutic Drug
Monitoring
Statistical Analysis
59% 46%
40%
52% 41% 49%
55% 41%
49%
7% 3%
77%
0%
20%
40%
60%
80%
100%
Mortality Mortality due to IFI Favourable outcome
Mucorales
Fusarium spp.
Yeasts
Dematiacenae
10%
11%
13%
13%
15%
23%
70%
GI tract
Skin
Bones
CNS
Soft tissue
Paranasal Sinus
Lungs
12%
21%
29%
33%
Skin
Soft tissue
Eyes
Paranasal Sinus
12%
14%
14%
28%
67%
CNS
Kidney
Liver
Lungs
Blood
13%
16%
21%
38%
49%
49%
Eyes
Paranasal Sinus
Soft tissue
Lungs
Skin
Blood
Fusarium
ae
