Mucormycosis in 2023: an update on pathogenesis and management

Frontiers in Cellular and Infection Microbiology, Journal Year: 2023, Volume and Issue: 13

Published: Sept. 21, 2023

Mucormycosis (MCR) is an emerging and frequently lethal fungal infection caused by the Mucorales family, with Rhizopus , Mucor Lichtheimia accounting for > 90% of all cases. MCR seen in patients severe immunosuppression such as those hematologic malignancy or transplantation, Diabetes Mellitus (DM) diabetic ketoacidosis (DKA) immunocompetent wounds. The recent SARS COV2 epidemy India has resulted a tremendous increase cases, typically setting uncontrolled DM corticosteroid use. In addition to diversity affected hosts, pleiotropic clinical presentations, rhino-orbital/rhino-cerebral, sino-pulmonary necrotizing cutaneous forms being predominant manifestations. Major insights pathogenesis have brought into focus host receptors (GRP78) signaling pathways (EGFR activation cascade) well adhesins used invasion. Furthermore, studies expanded on importance iron availability complex regulation homeostasis, pivotal role mycotoxins key factors tissue molecular toolbox study remains underdeveloped, but promise RNAi CRISPR/Cas9 approaches. Important advancements been made early, culture-independent diagnosis MCR. However, development new potent antifungals against unmet need. Therapy multidisciplinary requires high index suspicion initiation early Mucorales-active antifungals. Reversal underlying immunosuppression, if feasible, rapid DKA correction selected patients, surgical debulking are crucial improved outcomes.

Language: Английский

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Mucorales and Mucormycosis: Recent Insights and Future Prospects

Journal of Fungi, Journal Year: 2023, Volume and Issue: 9(3), P. 335 - 335

Published: March 9, 2023

The classification of Mucorales encompasses a collection basal fungi that have traditionally demonstrated an aversion to modern genetic manipulation techniques. This led scarcity knowledge regarding their biology compared other fungal groups. However, the emergence mucormycosis, disease caused by Mucorales, has attracted attention clinical field, mainly because available therapies are ineffective for decreasing fatal outcome associated with disease. revitalized curiosity about and also encouraged recent COVID-19 pandemic, spurred significant productive effort uncover mysteries in years. Here, we elaborate on most remarkable breakthroughs related recently discovered advances mucormycosis. utilization few study models enabled identification virulence factors were previously described pathogens. More notably, investigations identified novel genes mechanisms controlling pathogenic potential interactions host, providing fresh avenues devise new strategies against Finally, allowing studies hampered predicting prolific future field.

Language: Английский

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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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Impact of COVID-19 on mucormycosis presentation and laboratory values: A comparative analysis

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(5), P. e0321897 - e0321897

Published: May 2, 2025

Background The COVID-19 pandemic has led to an alarming increase in mucormycosis coinfections and its rapid progression. overlapping risk factors symptoms between further complicate prompt detection, which is crucial for patient survival. This study aims investigate potential differences progression, initial symptom presentation, laboratory value alterations patients with history enhance diagnostic accuracy improve outcomes this complex clinical scenario. Methodology retrospective cohort study, conducted from April 1, 2021, March 31, 2022, examined 102 diagnosed at two primary teaching hospitals. Patients were categorized into groups based on history. Variables included demographic information, parameters, results, outcomes. compared studies presentation history-positive history-negative groups, a particular focus mortality rates associated comorbidities such as diabetes, cancer immunosuppressive treatment. Results Initial presentations differed significantly, eneralized Estimating Equations (GEE) analysis, adjusted comorbidities, revealed was increased platelet counts (P = 0.0311) decreased facial swelling 0.049) fever reporting < 0.001). Cancer history, treatment also showed significant associations various parameters. Laboratory analysis without group lower WBC 0.002), higher hemoglobin levels 0.001) controls. Diabetes more prevalent patients, while common Conclusion reveals intricate relationships mucormycosis, challenging earlier findings. Mucormycosis exhibited altered presentation. research highlights varied patterns across subgroups underscores the complexity of interactions COVID-19, cancer, diabetes cases. These findings advocate multivariate analytical approaches better understand these multifaceted relationships.

Language: Английский

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Successful treatment of mixed pulmonary Aspergillus and Mucor infection using intrabronchial amphotericin B infusion: a case report and literature review

BMC Pulmonary Medicine, Journal Year: 2024, Volume and Issue: 24(1)

Published: Sept. 4, 2024

Language: Английский

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Pediatric Gastrointestinal Basidiobolomycosis: A Retrospective Study from Jazan Province, Saudi Arabia

Infection and Drug Resistance, Journal Year: 2023, Volume and Issue: Volume 16, P. 4667 - 4676

Published: July 1, 2023

Basidiobolomycosis is a rare fungal infection caused by Basidiobolus ranarum, and its incidence poorly understood due to rarity. Gastrointestinal (GIB) an uncommon presentation with limited reports in Saudi Arabia. This retrospective study aims describe risk factors, clinical findings, diagnosis, management of GIB the pediatric population.We conducted analysis all patients diagnosed at tertiary hospital between 2010 2022. Patients were identified based on their diagnosis GIB. A self-administered questionnaire was distributed assess factors associated GIB.We analyzed 25 cases GIB, approximately half (56%) occurring during COVID-19 pandemic. The mean age affected 6.6 years, male predominance (60%, n=15). About 100% parents acknowledged gecko existence residence, children exposed insect bites. Poor appetite reported patients, high counts eosinophils erythrocyte sedimentation rate observed. Thrombocytosis present 90% 87% had anemia. Abdominal computerized tomography scans ultrasound-guided biopsies most used diagnostic tools, being histopathological findings confirmed via culture.Our provides valuable information potential features, Jazan region. observed increase pandemic highlights need for continued surveillance research understand better epidemiology this infection. These emphasize heightened awareness, early detection, effective prevention strategies mitigate impact

Language: Английский

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Fungi that are medically relevant to humans and their prospect in a global warming scenario

Academia molecular biology and genomics., Journal Year: 2024, Volume and Issue: 1(1)

Published: Nov. 12, 2024

Language: Английский

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Risk Factors of COVID-19 associated mucormycosis in Iranian patients: a multicenter study

BMC Infectious Diseases, Journal Year: 2024, Volume and Issue: 24(1)

Published: Aug. 22, 2024

To evaluate the demographic, clinical, and prognostic characteristics of patients diagnosed with COVID-19-associated mucormycosis (CAM) in Iranian patients. This prospective observational study was conducted 8 tertiary referral ophthalmology centers different provinces Iran during fifth wave COVID-19 pandemic. All were subjected to complete history taking comprehensive ophthalmological examination underwent standard accepted treatment strategy based on disease stage. Two hundred seventy-four CAM (most males (150, 54.7%)) a mean age 56.8 ± 12.44 years enrolled. Patients cigarette smoking (Adjusted Odds Ratio (AOR) = 4.36), Intensive Care Unit admission (ICU) (AOR 16.26), higher stage 2.72), receiving endoscopic debridement transcutaneous retrobulbar amphotericin B 3.30) had odds mortality. History systemic corticosteroids significantly associated reduced mortality 0.16). Generalized Estimating Equations analysis showed that visual acuity deceased (LogMAR: 3.71, 95% CI: 3.04–4.38) worse than who discharged from hospital 2.42, 2.16–2.68) (P < 0.001). highlights significant risk factors for CAM, such as smoking, ICU admission, advanced stages, worser acuity. Conversely, corticosteroid use linked These findings underscore critical need early identification targeted interventions high-risk improve clinical outcomes.

Language: Английский

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Molecular docking studies of different phytochemicals obtained from medicinal Plants of Uttarakhand region for identification of potential inhibitors against mucormycosis causing fungal species

Journal of Applied and Natural Science, Journal Year: 2023, Volume and Issue: 15(1), P. 162 - 177

Published: March 19, 2023

Mucormycosis is an insidious fungal infection caused by members of Mucorales and zygomycotic species. During the last few years, mucormycosis has become third most common invasive in patients with haematological malignancies organ transplantations. The incidence particularly high immunocompromised health. It been reported that CotH receptor proteins have a potential role binding Rhizopus species host cells. Further, CotH1, CotH2, CotH3 are spore-coating protein mucormycosis, which mostly responsible for invasion cells causing diseases. present study aimed to predict structure receptors Rhizpous delemar using homology modelling on SWISS Server validated model based GMQE QMEAN scores followed analysis predicted Ramachandran plot. molecular docking studies predominant 46 phytochemicals found medicinal plants Uttarakhand region, India were done against these three receptors. Autodock vina results shown energy value Curcumin was -8.5 Kcal/mol Allosecurinin -7.6 CotH2 Isoquercetin -7.7 CotH3. Evaluation ADMET parameters efficacy compounds. Insilico suggests Curcumin, Allosecurinine, effective lead molecules R. delemar.

Language: Английский

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Immune and metabolic perturbations in COVID‐19‐associated pulmonary mucormycosis: A transcriptome analysis of innate immune cells

Mycoses, Journal Year: 2023, Volume and Issue: 67(1)

Published: Dec. 8, 2023

Abstract Background and Objectives The mechanisms underlying COVID‐19‐associated pulmonary mucormycosis (CAPM) remain unclear. We use a transcriptomic analysis of the innate immune cells to investigate host metabolic response pathways in patients with CAPM. Patients Methods enrolled subjects CAPM ( n = 5), (PM) without COVID‐19 (without mucormycosis, healthy controls 5) comorbid illness negative for SARS‐CoV‐2. Peripheral blood samples from cases were collected before initiating antifungal therapy, neutrophils monocytes isolated. RNA sequencing was performed using Illumina HiSeqX neutrophils. Raw reads aligned HISAT‐2 pipeline DESeq2 used differential gene expression. Gene ontology (GO) pathway Shiny GO application R packages (ggplot2, Pathview). Results derangement core responses noted. Pattern recognition receptors, dectin‐2, MCL, FcRγ receptors CLEC‐2, upregulated, but signalling such as JAK–STAT, IL‐17 CARD‐9 downregulated; mTOR MAP‐kinase elevated patients. complement NETosis, pro‐inflammatory responses, S100A8/A9, lipocalin MMP9, elevated. major glucose metabolism—glycolysis/gluconeogenesis, pentose phosphate pathway, HIF iron metabolism‐ferroptosis also upregulated Conclusions identified significant alterations possibly leading cellular overload hyperglycaemic state. Immune revealed altered recognition, signalling, effector functions state

Language: Английский

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