Epidemiology, clinical presentation and management of COVID‐19 associated mucormycosis: A single centre experience from Pune, Western India

Mycoses, Journal Year: 2022, Volume and Issue: 65(5), P. 526 - 540

Published: Feb. 25, 2022

The second COVID-19 wave in India has been associated with an unprecedented increase cases of mucormycosis (CAM), mainly Rhino-orbito-cerebral (ROCM).This retrospective cohort study was conducted at Noble hospital and Research Centre (NHRC), Pune, India, between 1 April, 2020, August, 2021, to identify CAM patients assess their management outcomes. primary endpoint incidence all-cause mortality due CAM.59 were diagnosed CAM. Median duration from the first positive RT PCR test diagnosis 17 (IQR: 12,22) days. 90% diabetic 89% having uncontrolled sugar level (HbA1c >7%). All prescribed steroids during treatment for COVID-19. 56% non-hypoxemic, mild (irrational steroid therapy), while 9%, inappropriately high dose. Patients treated a combination surgical debridement (94%), intravenous liposomal Amphotericin B (91%) concomitant oral Posaconazole (95.4%). 74.6% discharged after clinical radiologic recovery 25.4% died. On relative risk analysis, CT severity index ≥18 (p = .017), presence orbital symptoms .002), ketoacidosis .011) cerebral involvement .0004) increased death.CAM is rapidly progressive, angio-invasive, opportunistic fungal infection, which fatal if left untreated. Combination antifungal therapy leads improvement majority cases.

Language: Английский

---

Targeted Delivery of Antifungal Liposomes to Rhizopus delemar

Journal of Fungi, Journal Year: 2022, Volume and Issue: 8(4), P. 352 - 352

Published: March 30, 2022

Mucormycosis (a.k.a. zygomycosis) is an often-life-threatening disease caused by fungi from the ancient fungal division Mucoromycota. Globally, there are nearly a million people with disease. Rhizopus spp., and R. delemar (R. oryzae, arrhizus) in particular, responsible for most of diagnosed cases. Pulmonary, rhino-orbito-cerebral, invasive mucormycosis effectively treated amphotericin B (AmB) particularly liposomal formulations (e.g., AmBisome®). However, even after antifungal therapy, still 50% mortality rate. Hence, critical need to improve therapeutics mucormycosis. Targeting AmB-loaded liposomes (AmB-LLs) pathogen receptor Dectin-1 (DEC1-AmB-LLs) beta-glucans expressed on surface Aspergillus fumigatus Candida albicans lowers effective dose required kill cells relative untargeted AmB-LLs. Because immune infections may bind it directly, we explored Dectin-1-mediated delivery AmB delemar. DEC1-AmB-LLs bound 100- 1000-fold more efficiently exopolysaccharide matrix germlings mature hyphae delivering sub-micromolar concentrations were order magnitude efficient at inhibiting and/or killing than Targeted drug-loaded have potential treatment

Language: Английский

---

Clinical Features and Treatment Progress of Invasive Mucormycosis in Patients with Hematological Malignancies

Journal of Fungi, Journal Year: 2023, Volume and Issue: 9(5), P. 592 - 592

Published: May 19, 2023

The incidence rate of invasive mucormycosis (IM) in patients with hematological malignancies (HMs) is increasing year by year, ranging from 0.07% to 4.29%, and the mortality mostly higher than 50%. With ongoing pandemic COVID-19, COVID-19-associated (CAM) also became a global health threat. Patients high risk factors such as active HMs, relapsed/refractory leukemia, prolonged neutropenia may still develop breakthrough (BT-MCR) even under prophylaxis Mucorales-active antifungals, often have mortality. Rhizopus spp. most common genus associated IM, followed Mucor Lichtheimia Pulmonary (PM) form IM rhino-orbital-cerebral (ROCM) disseminated mucormycosis. prognosis neutrophil recovery, localized receiving early combined medical–surgical therapy usually better. As for management disease, should be eliminated firstly. Liposome amphotericin B (L-AmB) surgery initial treatment scheme IM. Those who are intolerant L-AmB can choose intravenous formulations or tablets isavuconazole posaconazole. refractory monotherapy turn antifungals therapy.

Language: Английский

---

Antifungal Policy and Practice Across Five Countries: A Qualitative Review

Journal of Fungi, Journal Year: 2025, Volume and Issue: 11(2), P. 162 - 162

Published: Feb. 19, 2025

The burden of invasive fungal infections (IFIs) is increasing worldwide. National, regional, and local policies on IFI management should respond to the changing landscape. We assessed antifungal from five countries varying size, burden, geography: Netherlands, Italy, South Korea, China, India. These were selected as a representative sample reflecting different types economic health systems that patients providers access This assessment focused comprehensive range policy elements, including recognition prioritization, awareness education, prevention monitoring, diagnosis coordinated care, appropriate treatment, diagnostic treatment innovation. Although in this analysis all have some form for management, we identified substantial gaps, low prioritization diagnostics, omission pathogens antimicrobial resistance policies, general lack healthcare professional (HCP) training management. gaps are intended inform HCPs policy- decision-makers about aspects consider reducing while demonstrating responsible stewardship.

Language: Английский

---

Evaluating Risk Factors for COVID-19-associated Mucormycosis: Insights from a Case Series

Published: March 8, 2025

Language: Английский

---