Epidemiology, Modern Diagnostics, and the Management of Mucorales Infections

Journal of Fungi, Journal Year: 2023, Volume and Issue: 9(6), P. 659 - 659

Published: June 12, 2023

Mucormycosis is an uncommon, yet deadly invasive fungal infection caused by the Mucorales moulds. These pathogens are a WHO-assigned high-priority pathogen group, as mucormycosis incidence increasing, and there unacceptably high mortality with current antifungal therapies. Current diagnostic methods have inadequate sensitivity specificity may issues accessibility or turnaround time. Patients diabetes mellitus immune compromise predisposed to these environmental fungi, but COVID-19 has established itself new risk factor. also cause healthcare-associated outbreaks, clusters associated natural disasters been identified. Robust epidemiological surveillance into burden of disease, at-risk populations, emerging required. Emerging serological molecular techniques offer faster route diagnosis, while newly developed agents show promise in preliminary studies. Equitable access therapies will be key identifying treating mucormycosis, delayed initiation therapy higher mortality.

Language: Английский

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Severe mold fungal infections in critically ill patients with COVID-19

Future Microbiology, Journal Year: 2024, Volume and Issue: 19(9), P. 825 - 840

Published: May 31, 2024

The SARS-CoV-2 pandemic put an unprecedented strain on modern societies and healthcare systems. A significantly higher incidence of invasive fungal co-infections was noted compared with the pre-COVID-19 era, adding new diagnostic therapeutic challenges in critical care setting. In current narrative review, we focus mold infections caused by Aspergillus Mucor species critically ill COVID-19 patients. We discuss up-to-date information incidence, pathogenesis, diagnosis treatment these mold-COVID-19 co-infections, as well recommendations preventive prophylactic interventions. Traditional risk factors were often not recognized COVID-19-associated aspergillosis mucormycosis, highlighting role other determinant factors. associated patient outcomes worse patients without co-infection.

Language: Английский

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Survival and prognostic factors in rhino-orbito-cerebral mucormycosis: A 3-year cohort study

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: May 8, 2025

Mucormycosis, a severe fungal infection, has exhibited concerning increase in recent years, particularly during the COVID-19 outbreak. This three-year cohort study aims to investigate an overview of epidemiology, clinical and radiographic signs, treatment, prognosis Rhino-Orbito-Cerebral Mucormycosis (ROCM). prospective was conducted from 2019 2022 at Khalili Hospital Shiraz, Iran. It focused on proven cases ROCM. Patients underwent stepwise treatment protocol, with meticulous documentation findings ophthalmological examinations imaging studies. Additionally, follow-up period implemented monitor patient progress assess effectiveness strategies. Statistical analyses were performed using IBM SPSS statistics. In this study, 77 patients ROCM participated. Most presented facial pain (75.3%), swelling (62.3%), vision loss (51.9%). Treatment included combined antifungal therapy surgical debridement, 7.8% undergoing ocular exenteration. Notably, despite extensive disease, all that orbital exenteration survived 3-year follow-up. Impaired V2 nerve function associated higher mortality rates, presenting initial visual acuity No Light Perception (NLP) had compared those other degrees impairment. The convergence mucormycosis, specifically form ROCM, led outbreak characterized by high morbidity rates. meticulously documented long-term these patients, aiming provide novel insights into infection.

Language: Английский

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The potential for rapid antigen testing for mucormycosis in the context of COVID-19

Expert Review of Molecular Diagnostics, Journal Year: 2023, Volume and Issue: 24(3), P. 161 - 167

Published: July 5, 2023

ABSTRACTABSTRACTIntroduction Mucormycosis is a highly aggressive angio-invasive disease of humans caused by Mucorales fungi. Prior to the COVID-19 pandemic, mucormycosis was rare mycosis typically seen in immunocompromised patients with hematological malignancies or transplant recipients. During second wave there dramatic increase disease, especially India where unique set circumstances led large numbers life-threatening and disfiguring rhino-orbital-cerebral (ROCM) infections.Areas covered The review examines as super-infection patients, risk factors for COVID-19-associated (CAM) that drove ROCM epidemic India. limitations current diagnostic procedures are identified, measures needed improve speed accuracy detection discussed.Expert opinion Despite improved recognition, global healthcare systems remain unprepared further outbreaks ROCM. Current diagnosis slow inaccurate, negatively impacting on patient survival. This most evident low- middle-income countries which lack suitably equipped facilities rapid identification infecting pathogens. Rapid antigen testing using point-of-care lateral-flow assays could potentially have aided quick accurate allowing earlier intervention surgery Mucorales-active antifungal drugs.KEYWORDS: MucoralesRhino-orbital-cerebral (ROCM)COVID-19-associated (CAM)rapid testPoint-of-care test (POCT)lateral-flow technologyDisclaimerAs service authors researchers we providing this version an accepted manuscript (AM). Copyediting, typesetting, resulting proofs will be undertaken before final publication Version Record (VoR). production pre-press, errors may discovered affect content, all legal disclaimers apply journal relate these versions also. Article HighlightsMucormycosis second-most common mold after invasive aspergillosis, infections patients.The pandemic saw uncontrolled diabetes indiscriminate use corticosteroids contributed infections.The paucity rapid, sensitive tests countries, high rates mortality morbidity (CAM).Rapid technology enabled resource-limited settings.A incorporates monoclonal antibody specific Rhizopus arrhizus, principal agent ROCM, has been developed rapidly deployed POCT disease.Declaration interestThe author affiliated ISCA Diagnostics Limited.The Potential Antigen Testing Context COVID-19All authorsChristopher R. Thornton https://doi.org/10.1080/14737159.2023.2233906Published online:05 July 2023Figure 1. Clinical manifestations infection Following inhalation air-borne sporangiospores released from sporangia (blue structures), rapidly-progressive paranasal sinuses hyphae can lead (ROCM). categorised as: localised sinus, orbital, cerebral, sino-orbital, sino-cerebral, rhino-cerebral generalised Inhalation spores into lungs result deep extension (infections involve lungs, chest wall, heart, artery aorta) pulmonary mucormycosis, while necrotising cutaneous traumatic implant infective propagules skin disseminated liver, spleen, other organs following hematogenous spread fungi sites infection. Image courtesy Shutterstock.Display full sizeFigure Shutterstock.Additional informationFundingThis paper not funded.

Language: Английский

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Risk Factors, Clinical Manifestations, and Outcomes of COVID-19-Associated Mucormycosis and Other Opportunistic Fungal Infections

Cureus, Journal Year: 2023, Volume and Issue: unknown

Published: Sept. 30, 2023

An epidemic of opportunistic fungal infections during the second wave coronavirus disease 2019 (COVID-19) pandemic badly affected India in 2021. Several unknown, unique factors played a role its causation and survival outcomes, including severe acute respiratory syndrome 2 (SARS-CoV-2) infection. The purpose this study was to analyse probable underlying risk know immediate late outcomes setting SARS-CoV-2 pandemic.In retrospective cohort study, clinical records COVID-19-associated were reviewed for factors, features, microbiological pathological findings, one-year follow-up at tertiary care teaching hospital Northern India.A total 390 patients admitted with symptoms signs consistent criteria diagnosis mucormycosis (CAM). Diabetes mellitus most common comorbidity (74%). During management SARS-CoV-2, 192 (49%) received corticosteroids, 151 (39%) on oxygen support, 143 (37%) used at-home steam inhalation. Masks any type by 236 (60.5%) patients, whom cloth masks (n=147, 37.6%). Microbiologically, growth positive 138 (35.3%) samples; these, 74 (19%) had non-Mucorales colonies. infection invaded structures beyond paranasal sinuses 60% cases. overall mortality after 40.25%.An alignment several predisposing conditions precipitated an COVID-19 that resulted high patients.

Language: Английский

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Rise of mucormycosis during the COVID-19 pandemic and the challenges faced.

PubMed, Journal Year: 2023, Volume and Issue: 9(1), P. 44 - 55

Published: March 1, 2023

Mucormycosis (previously called zygomycosis) is a diverse group of increasingly recognized and frequently fatal mycotic diseases caused by members the class zygomycetes. around 80 times more common in India, compared to other developed countries, with frequency 0.14 cases per 1,000 population. The most frequent causative agent mucormycosis following genera from Order Mucorales Rhizopus, Mucor, Rhizomucor, Absidia, Apophysomyces, Cunninghamella, Saksenaea. major risk factors for development are diabetic ketoacidosis, deferoxamine treatment, cancer, solid organ or bone marrow transplantations, prolonged steroid use, extreme malnutrition, neutropenia. clinical forms rhino-orbital-cerebral, pulmonary, cutaneous, gastrointestinal. During second wave COVID-19, there was rapid increase severity than before. Amphotericin B currently found be an effective drug as it have broad-spectrum activity posaconazole used salvage therapy. Newer triazole isavuconazole also against mucormycosis. This study aimed review various studies on laboratory diagnosis treatment

Language: Английский

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COVID-19 associated rhino-orbital-cerebral mucormycosis in patients with diabetes and comorbid conditions

Elsevier eBooks, Journal Year: 2024, Volume and Issue: unknown, P. 473 - 483

Published: Jan. 1, 2024

Language: Английский

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Factors Influencing Mortality in COVID-19-Associated Mucormycosis - The International ID-IRI Study

Medical Mycology, Journal Year: 2024, Volume and Issue: 62(7)

Published: June 24, 2024

The emergence of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global pandemic. Concurrently, reports mucormycosis cases surged, particularly during the second wave in India. This study aims to investigate mortality factors COVID-19-associated (CAM) cases, exploring clinical, demographic, and therapeutic variables across mostly Asian partly African countries. A retrospective, cross-sectional analysis CAM patients from 22 medical centers eight countries was conducted, focusing on first 3 months post-COVID-19 diagnosis. Data collected through ID-IRI included demographics, comorbidities, treatments, outcomes. total 162 were included. mean age 54.29 ± 13.04 years, with 54% male. Diabetes mellitus (85%) prevalent, 91% had rhino-orbital-cerebral mucormycosis. Surgical debridement performed 84% cases. Mortality 39%, advanced (hazard ratio [HR] = 1.06, [P < .001]), rituximab use (HR 21.2, P .05), diabetic ketoacidosis 3.58, .009) identified as risk factors. increases approximately 5.6% for each additional year age. based organ involvement correlated higher survival 8.81, .001). utilization ketoacidosis, along advancing age, has been associated an increased patients. combination antifungal treatment surgical intervention demonstrated substantial improvement

Language: Английский

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Management of severe COVID-19 in the ICU

European Respiratory Society eBooks, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 27, 2024

Language: Английский

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