<i>Notes from the Field</i>: Mucormycosis Cases During the COVID<b>-</b>19 Pandemic — Honduras, May–September 2021

Mejía-Santos, Homer; Montoya, Sandra; Chacón-Fuentes, Rafael; Zielinski-Gutiérrez, Emily; López, Beatriz Ramírez; Ning, Mariangeli Freitas; Farach, Nasim; García-Coto, Fany; Rodríguez-Araujo, David S; Rosales-Pavón, Karla; Urbina, Gustavo; Rivera, Ana Carolina; Pena, R; Tovar, A; Paz, Mitzi Castro; Lopez, Roque; Pardo-Cruz, Fabian; Mendez, Carol; Flores, Angel; Varela, Mirna; Chiller, Tom; Jackson, Brendan R; Jordan, Alexander; Lyman, Meghan; Toda, Mitsuru; Cáceres, Diego H.; Gold, Jeremy A W

doi:10.15585/mmwr.mm7050a2

Cited by 12 publications

(12 citation statements)

References 4 publications

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“…Added to this, the high morbidity of symptomatic infections by COVID- 19 [44] generates a population at high risk of infection by MM-producing fungi in Honduras. In 2021, an epidemiological follow-up was published by the Ministry of Health of Honduras with the support of the PAHO and the CDC of USA, of a group of 17 patients with MM from four geographically distant hospitals in Honduras [15]. 11 of those 17 cases were associated with COVID-19, 12 patients had underlying diabetes, and 2 had proliferative hematologic disorders.…”

Section: Discussionmentioning

confidence: 99%

First Molecular Identification of Three Clinical Isolates of Fungi Causing Mucormycosis in Honduras

Ortiz¹,

Laínez-Arteaga²,

Galindo-Morales³

et al. 2022

Preprint

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Mucormycoses are rare but serious opportunistic fungal infections caused by filamentous organisms of the order Mucorales. Here we report the first molecular identification of Rhizopus oryzae (heterotypic synonym Rhizopus arrhizus), R. delemar, and Apophysomyces ossiformis as the etiological agents of three cases of severe mucormycosis in Honduras. Conventional microbiological cultures were carried out, and DNA was extracted from both clinical samples and axenic cultures. The ITS ribosomal region was amplified and sequenced. Molecular tools are suitable strategies for diagnosing and identifying Mucorales in tissues and cultures, especially in middle-income countries lacking routine diagnostic strategies.

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Section: Discussionmentioning

confidence: 99%

First Molecular Identification of Three Clinical Isolates of Fungi Causing Mucormycosis in Honduras

Ortiz¹,

Laínez-Arteaga²,

Galindo-Morales³

et al. 2022

Preprint

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“…We read the article by Watanabe et al with interest wherein the authors performed a systematic review of literature on COVID-19-associated mucormycosis (CAM) and estimated the pooled mortality at 29% [1]. Unfortunately, the authors have missed several peer-reviewed articles published before January 20, 2022 [2][3][4][5]. These studies had a larger proportion of pulmonary mucormycosis [2,4], reported higher mortality (73-88%) [2,5], and including them might have yielded a different result.…”

Section: Sirmentioning

confidence: 99%

“…Unfortunately, the authors have missed several peer-reviewed articles published before January 20, 2022 [2][3][4][5]. These studies had a larger proportion of pulmonary mucormycosis [2,4], reported higher mortality (73-88%) [2,5], and including them might have yielded a different result. Danion et al reported 17 CAM cases from France with a mortality of 88% at twelve weeks.…”

Section: Sirmentioning

confidence: 99%

COVID-19-Associated Pulmonary Mucormycosis: An Underdiagnosed Entity with High Mortality

2022

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“…During the COVID-19 pandemic, the use of immunomodulatory drugs (e.g., systemic corticosteroids and tocilizumab) and COVID-19-induced immune dysregulation increased the risk of mucormycosis (9,10). Cases of COVID-19-associated mucormycosis (CAM) have been reported worldwide (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and have been mostly associated with underlying uncontrolled diabetes mellitus diseases. Nevertheless, cutaneous and soft-tissue mucormycosis has been observed in immunocompetent individuals (21,22), such as those induced by traumatic implantation of contaminated soil and water during tornadoes (23).…”

Section: Mucormycosis Is a Devastating Invasive Fungal Infection Pred...mentioning

confidence: 99%

Is the production of reactive oxygen and nitrogen species by macrophages associated with better infectious control in the experimental disseminated and pulmonary mucormycosis?

Santos

Fraga-Silva

Donanzam

et al. 2022

Preprint

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Different levels of resistance againstRhizopus oryzaeinfection have been observed between inbred (BALB/c) and outbred (Swiss) mice, with is associated with the genetic background of each mouse strain. Considering that macrophages play an important role in host resistance toRhizopusspecies, we use the different infectious outcomes observed in experimental mucormycosis to identify the most efficient macrophages responses pattern againstR. oryzae in vitroandin vivo. For this, we compared BALB/c and Swiss macrophage activity pre-and-post intravenous or intratrachealR. oryzaeinfections. Production of hydrogen peroxide (H2O2) and nitric oxide (NO) was determined in cultures of peritoneal (PMΦ) or alveolar macrophages (AMΦ) challenged, or not, with heat-killed spores ofR. oryzae. Levels of TNF-α and IL-10 were also measured to enhance our findings. Naïve PMΦ from BALB/c increased the production of H2O2, TNF-α, and IL-10 in the presence of heat-killed spores ofR. oryzae, while naïve PMΦ from Swiss mice was less responsive. Naïve AMΦ from two strains of mice were less reactive to heat-killed spores ofR. oryzaethan PMΦ. On 30 days ofR. oryzaeintravenous infection, lower fungal load in BALB/c strain of mice was accompanied by higher production of H2O2by PMΦ when compared with Swiss mice. Differently, AMΦ from BALB/c mice showed higher production of NO, TNF-α, and IL-10 after 7 days of intratracheal infection and after 30 days, lower fungal load, when compared with Swiss mice. According to the set of experiments performed, our findings reveal that independently of mice strain, PMΦ is more reactive againstR. oryzaein the first contact than AMΦ. In addition, increased PMΦ production of H2O2at the end of disseminated infection is related to efficient fungal clearance observed in resistant (BALB/c). Our findings provide new evidence to understand the parasite-hosts relationship in mucormycosis.

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Notes from the Field: Mucormycosis Cases During the COVID-19 Pandemic — Honduras, May–September 2021

Cited by 12 publications

References 4 publications

First Molecular Identification of Three Clinical Isolates of Fungi Causing Mucormycosis in Honduras

First Molecular Identification of Three Clinical Isolates of Fungi Causing Mucormycosis in Honduras

COVID-19-Associated Pulmonary Mucormycosis: An Underdiagnosed Entity with High Mortality

Is the production of reactive oxygen and nitrogen species by macrophages associated with better infectious control in the experimental disseminated and pulmonary mucormycosis?

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