Epidemiology, clinical features, therapeutic interventions and outcomes of mucormycosis in Shiraz: an 8-year retrospective case study with comparison between children and adults

Motamedi, Marjan; Golmohammadi, Zahra; Yazdanpanah, Somayeh; Saneian, S. Mojtaba; Shafiekhani, Mojtaba

doi:10.1038/s41598-022-21611-8

Cited by 6 publications

(1 citation statement)

References 56 publications

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“…Mucormycosis is a rare infection in children; therefore, there are few case studies in the literature. An 8-year retrospective study conducted on 164 patients in Iran determined that approximately one-quarter of the total population with mucormycosis comprised children (10). It has been stated that type 2 diabetes and widespread corticosteroid use may be responsible for the increase in mucormycosis with the COVID-19 pandemic in India.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Associated Mucormycosis and Risk Factors: A Case-Control Study from Turkey

Kılınç Toker,

Turunc Ozdemir,

Kanat

et al. 2024

Jundishapur J Microbiol

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Background: Mucormycosis, a fatal fungal infection, has increased during the COVID-19 pandemic and posed significant challenges for clinicians. Objectives: Our research focused on identifying the clinical traits of patients with COVID-19-associated mucormycosis (CAM), comparing them with a control group, and identifying risk factors for the development of CAM. Methods: Our study was conducted on 39 CAM patients and 78 control patients from September 2020 to October 2022 at a tertiary education center and regional hospital. The control group was selected blindly in a 1:2 ratio among patients who did not develop mucormycosis, were hospitalized due to COVID-19, and were either discharged or deceased. The control group was matched to the case group regarding age and hospitalization date. To test potential risk factors for CAM, we performed a binary logistic regression analysis. The variables included in the multivariate binary logistic regression model were gender, diabetes, cumulative steroid dose (dexamethasone equivalent), duration of steroid treatment, and tocilizumab/anakinra treatment. Results: In our study, 39 patients were diagnosed with CAM. The average age of the patients was 66 ± 11.5 years. Of the patients, 54.7% (n = 64) were male, with a statistically significantly higher proportion of men in the CAM group (74.4% vs. 44.9%, P = 0.003). The diabetes rate was 51.3% (n = 60) among all patients, and it was higher in the CAM group (69.2% vs. 42.3%, P = 0.006). Regarding in-hospital mortality, the rate was higher in the CAM group (56.4% vs. 14.1%, P < 0.001). The median length of stay in the hospital was 37 days for the CAM group and 10 days for the control group (P < 0.001). The cumulative steroid dose was elevated in the CAM group compared to the control group (191 ± 61.4 mg vs. 117 ± 69.8 mg, P < 0.001). The duration of steroid treatment was 16.5 ± 6.2 days in the CAM group, compared to 9.8 ± 4.7 days in the control group (P < 0.001). Among CAM cases, paranasal involvement was the most common (56.4%), followed by rhino-orbital involvement (33.3%). In binary logistic regression analysis, male gender (OR, 3.9; 95% CI, 1.4 – 11.3), diabetes mellitus (OR, 4.4; 95% CI, 1.5 – 12.4), more than ten days of steroid use (OR, 5.5; 95% CI, 1.3 – 22.4), and tocilizumab/anakinra use (OR, 0.23; 95% CI, 0.06 – 0.8) were identified as risk factors for the development of CAM (p values 0.011, 0.005, 0.019, and 0.020, respectively). Conclusions: Male gender, diabetes mellitus, and steroid use for more than ten days were identified as positive risk factors, while tocilizumab/anakinra use was identified as a negative risk factor for the development of CAM.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Associated Mucormycosis and Risk Factors: A Case-Control Study from Turkey

Kılınç Toker,

Turunc Ozdemir,

Kanat

et al. 2024

Jundishapur J Microbiol

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Mycological contamination of cabin filters as a potential source of air pollution inside passenger vehicles

Farian,

Wójcik-Fatla

2024

Air Qual Atmos Health

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Microbiological pollutants of cabin filters may affect the air quality inside vehicles. The main aim of the study was to evaluate cabin filters in terms of their effectiveness in retaining mycological contaminants. The research material consisted of 100 cabin filters obtained during periodic replacement of filters in passenger cars. Mycological contamination of filters was examined using microbiological, biochemical, immunoenzymatic and molecular methods. The average concentration of fungi in cabin filters was 7.2 × 107 CFU/m2, and Cladosporium, Alternaria, Penicillium, and Aspergillus genera were most often isolated. For Aspergillus species, the highest concentration reached 3.3 × 107 CFU/m2, with dominance of A. fumigatus. Among the Aspergillus strains tested, the presence of the aflO gene related to aflatoxin biosynthesis and the polyketide synthase gene related to ochratoxin A biosynthesis was detected. The presence of total aflatoxin (B1, B2, G1, G2) and aflatoxin B1 was detected at levels of 5.37 µg/kg and 1.71 µg/kg for standard filters and 2.43 µg/kg and 0.65 µg/kg for carbon filters. The level of ochratoxin A contamination was 0.96 µg/kg and 0.55 µg/kg for standard and carbon filters, respectively. Aspergillus species showed high enzymatic activity of acid phosphatase, β-glucosidase, naphthol phosphohydrolase and N-acetyl-β-glucosamidase. Based on the test results regarding the concentration of mycotoxins and the effectiveness of capturing fungal conidia, it was found that carbon filters are more effective than standard filters. Recommendations for filter manufacturers and car service policies should include the use of cabin filters with a layer of activated carbon, and their regular replacement after a year of use.

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Diagnosis and rehabilitation of an infant with palatal mucormycosis: A clinical report and systematic literature review

Bemquerer,

de Arruda,

Costa

et al. 2024

The Journal of Prosthetic Dentistry

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Epidemiology, clinical features, therapeutic interventions and outcomes of mucormycosis in Shiraz: an 8-year retrospective case study with comparison between children and adults

Cited by 6 publications

References 56 publications

COVID-19 Associated Mucormycosis and Risk Factors: A Case-Control Study from Turkey

COVID-19 Associated Mucormycosis and Risk Factors: A Case-Control Study from Turkey

Mycological contamination of cabin filters as a potential source of air pollution inside passenger vehicles

Diagnosis and rehabilitation of an infant with palatal mucormycosis: A clinical report and systematic literature review

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