<i>Trichosporon</i> species bloodstream infections in a tertiary care hospital in the western region of Saudi Arabia: A 7-year retrospective chart review from 2016 to 2022

Despite advances in medical mycology, invasive Trichosporon spp. infections continue to be associated with high mortality rates. Limited data exist on the risk factors and outcomes of Trichosporon fungemia, particularly in our region. Therefore, this study aims to describe the risk factors, patient characteristics, antifungal susceptibility, and outcome of Trichosporon bloodstream infections at a tertiary care hospital in Saudi Arabia. This was a single-center retrospective chart review that included adult patients ≥ 16 years with positive blood cultures for Trichosporon spp. from January 2016 to December 2022. Descriptive statistics are presented using the mean for continuous variables and the number (percentage) for categorical variables. Ten patients with Trichosporon spp. isolated from blood cultures were eligible for inclusion in this study. The mean age was 58.1 years (range 17-83), with 70% male patients. Additionally, 40% had diabetes mellitus, and 40% had underlying malignancy. Trichosporon asahii was the predominant species in 90% of isolates. All patients had recent broad-spectrum antibiotic use, 80% were exposed to corticosteroids, and all had central venous catheters. One kidney transplant had an early recurrence of Trichosporon spp. fungemia. Four patients were cured of the infection, two were treated with voriconazole monotherapy, and two were treated with a combination of liposomal amphotericin B plus Voriconazole. Thirty-day all-cause mortality was 60%, with three deaths occurring before identification of the isolates. In conclusion, our study reported a predominance of Trichosporon asahii and a mortality rate of 60% in patients with Trichosporon fungemia. Challenges include delayed diagnosis, high mortality, and antifungal resistance, underscoring the need for further research to enhance treatment strategies and patient outcomes.