Background. Trichosporon species have emerged as an important non-Candida spp yeast pathogen in immunocompromised patients in recent decades; however, the systemic analysis of Trichosporon epidemiology has seldom been reported. Methods. We reviewed 185 reported cases of Trichosporon
fungemia from 1975 to 2014 in the English-language literature, and the epidemiology and prognostic factors of the included cases are described. Results. The number of cases reported has increased with time, especially over the past decade. During the 3 decades from 1975 to 2004, the most commonly used antifungal compounds were
amphotericin B/
liposomal amphotericin B; however, in recent decades (2005-2014),
triazoles (especially
voriconazole) have become the most widely used agents, significantly improving outcome in the reported cases. Correlation analysis revealed that negative outcome is associated with several prognostic factors, including a history of antimicrobial use, bacterial bloodstream
coinfection, prophylactic/empirical antifungal
therapy, Trichosporon beigelii
infection, and receiving the antifungal regimen of
amphotericin B/
liposomal amphotericin B. In addition, a significantly greater proportion of patients with a positive outcome had
fungemia without invasive tissue
infection and received a
voriconazole regimen or an AmB-
triazole combined regimen. Significant positive outcome was also associated with patients who had recovered from
neutropenia or after
central venous catheter removal. Conclusions. Voriconazole can be recommended as a first-line antifungal compound to treat Trichosporon
fungemia; the immune status of the host plays a crucial role in the outcome of this
infection, and the removal of
vascular catheters should be considered if feasible.