Mucorales: A systematic review to inform the World Health Organization priority list of fungal pathogens

Title
Mucorales: A systematic review to inform the World Health Organization priority list of fungal pathogens
Publication Date
2024-06
Author(s)
Morrissey, C Orla
Kim, Hannah Yejin
( author )
OrcID: https://orcid.org/0000-0002-1808-5036
Email: hkim41@une.edu.au
UNE Id une-id:hkim41
Garnham, Katherine
Dao, Aiken
Chakrabarti, Arunaloke
Perfect, John R
Alastruey-Izquierdo, Ana
Harrison, Thomas S
Bongomin, Felix
Galas, Marcelo
Siswanto, Siswanto
Dagne, Daniel Argaw
Roitberg, Felipe
Gigante, Valeria
Sati, Hatim
Alffenaar, Jan-Willem
Beardsley, Justin
Type of document
Journal Article
Language
en
Entity Type
Publication
Publisher
Oxford University Press (OUP)
Place of publication
United Kingdom
DOI
10.1093/mmy/myad130
UNE publication id
une:1959.11/73536
Abstract

The World Health Organization, in response to the growing burden of fungal disease, established a process to develop a fungal priority pathogens list (FPPL). This systematic review aimed to evaluate the epidemiology and impact of invasive fungal disease due to Mucorales. PubMed and Web of Science were searched to identify studies published between January 1, 2011 and February 23, 2021. Studies reporting on mortality, inpatient care, complications and sequelae, antifungal susceptibility, risk factors, preventability, annual incidence, global distribution, and emergence during the study time frames were selected. Overall, 24 studies were included. Mortality rates of up to 80% were reported. Antifungal susceptibility varied across agents and species, with the minimum inhibitory concentrations lowest for amphotericin B and posaconazole. Diabetes mellitus was a common risk factor, detected in 65%–85% of patients with mucormycosis, particularly in those with rhino-orbital disease (86.9%). Break-through infection was detected in 13.6%–100% on azole or echinocandin antifungal prophylaxis. The reported prevalence rates were variable, with some studies reporting stable rates in the USA of 0.094–0.117/10 000 discharges between 2011 and 2014, whereas others reported an increase in Iran from 16.8% to 24% between 2011 and 2015. Carefully designed global surveillance studies, linking laboratory and clinical data, are required to develop clinical breakpoints to guide antifungal therapy and determine accurate estimates of complications and sequelae, annual incidence, trends, and global distribution. These data will provide robust estimates of disease burden to refine interventions and better inform future FPPL.

Link
Citation
Medical Mycology, 62(6), p. 1-24
ISSN
1460-2709
1369-3786
Start page
1
End page
24
Rights
Attribution-NonCommercial 4.0 International

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