伊朗8个三级医疗中心601例毛霉菌病患者的10年观察

IF 2.9 3区 生物学 Q2 MYCOLOGY
Hamid Badali, Bahar Mohamadi, Shahram Mahmoudi, Maryam Nasirian, Siavash Amiri, Shirin Irani, Zeynab Yassin, Narges Vaseghi, Ilad Alavi Darazam, Mohammadreza Salehi, Maryam Roham, Sara Abolghasemi, Farshad Divsalar, Mehrdad Hasibi, Atousa Hakamifard, Maryamosadat Hashemi Bafghi, Simin Saberi, Afsane Vaezi
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引用次数: 0

摘要

背景:毛霉菌病是由毛霉菌目真菌引起的一种罕见的、破坏性的、危及生命的血管侵袭性真菌感染。本研究表明,迫切需要在这方面进行更广泛的研究。我们的目的是评估十年(2010-2020年)伊朗八个三级保健中心毛霉病的流行病学。方法:在回顾性研究中,根据组织病理学阳性和氢氧化钾(KOH)直接显微镜检查纳入符合条件的患者。数据收集始于2021年7月26日,包括2010年2月15日至2020年5月16日的数据。结果:糖尿病是毛霉病的主要发病基础。鼻-脑、鼻-鼻和鼻-鼻-眶感染分别占53.2%、23.8%和23%。108例培养菌中,根霉属菌最多,毛霉属菌次之。超过一半的患者接受了手术/抗真菌治疗,研究期间总体抗真菌处方率为66.7%。然而,手术比手术/抗真菌治疗有更好的临床结果。处方抗真菌药物主要为两性霉素B、泊沙康唑和两性霉素-泊沙康唑。大多数毛霉感染患者在夏季入院。确诊病例的总死亡率为30.6%,其中诊断为肺部感染的患者死亡率最高。结论:目前的研究是该主题最大的单一国家回顾性研究,有601例毛霉病病例。它可能会发现知识上的空白,为未来的研究提出建议,并阐明毛霉病的临床和流行病学方面。然而,未来的研究和澄清毛霉病的临床和流行病学方面是强烈建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ten-Year Experience on 601 Patients with Mucormycosis at Eight Tertiary Care Centers in Iran.

Background: Mucormycosis is a rare, destructive, and life-threatening angio-invasive fungal infection caused by fungi of the order Mucorales. This study highlights the urgent need for more extensive research in this regard. We aimed to assess the epidemiology of mucormycosis at eight tertiary-care centers in Iran over ten years (2010-2020).

Methods: In the current retrospective study, eligible patients were included based on positive histopathology and direct microscopy by potassium hydroxide (KOH). Data collection started on July 26, 2021, and included data from February 15, 2010, to May 16, 2020.

Results: Diabetes mellitus was the chief underlying condition related to mucormycosis. Rhino-cerebral, rhino-sino, and rhino-sino-orbital infections were observed in 53.2%, 23.8%, and 23% of these patients. Among the 108 cases with a culture, Rhizopus species were the most prevalent, followed by Mucor species. Over half of the patients received surgery/antifungal treatment, with an overall antifungal prescribing rate of 66.7% of patients within the study period. However, surgery was associated with better clinical outcomes than surgery/antifungal treatment. The antifungals prescribed were mainly amphotericin B, posaconazole, and amphotericin-posaconazole. Most patients with mucormycosis infection were admitted in the summer. Overall mortality in the identified cases was 30.6%, with the highest mortality rate in patients diagnosed with pulmonary infection.

Conclusion: The current study is the largest single-country retrospective study on the topic, with 601 mucormycosis cases. It may uncover gaps in knowledge, develop recommendations for future studies, and clarify the clinical and epidemiological aspects of mucormycosis. However, future studies and clarification of mucormycosis's clinical and epidemiological aspects are highly recommended.

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来源期刊
Mycopathologia
Mycopathologia 生物-真菌学
CiteScore
6.80
自引率
3.60%
发文量
76
审稿时长
3 months
期刊介绍: Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.
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