Epidemiology of zygomycosis in mainland China

Abstract

Abstract: Objective To understand the epidemiology of zygomycosis and the status of diagnosis and treatment in mainland China.Methods Literature from 1976 to 2010 were collected by CNKI and Pubmed and statistically analyzed.Results A total of 206 cases and 428 patients were included in our study. The most common infections of gastrointestinal, pulmonary, sinus and cutaneous sites were often secondary to diabetes, gastrointestinal ulceration, burns, surgery, trauma, or no underlying conditions. Etiology diagnosis depended on direct microscopy, culture and pathology, and only 6 cases identified by molecular biology. The antifungal therapy was the main treatment and amphotericin B was the first choice in most cases. The mortality was 29.43% (126/428).Conclusion s Zygomycosis in mailand China had emerged as an increasingly important fungal infection which was in concordance with the world. Gastrointestinal tract was the most popular involvement. Morphological and molecular biological identification are important for accurate and prompt diagnosis. In vitro susceptibility test is helpful for clinical treatment.

Key words: zygomycosis, species identification, diagnosis, treatment

CLC Number:

R379.9

WANG Si-bu, LI Ruo-yu, YU jin. Epidemiology of zygomycosis in mainland China[J]. Chinese Journal of Mycology, 2013, 8(3): 163-168.

References

[1] Bitar D, Van Cauteren D, Lanternier F, et al. Increasing incidence of zygomycosis (mucormycosis), France, 1997-2006[J]. Emerg Infect Dis, 2009, 15(9):1395-1401.
[2] Kontoyiannis DP, Marr KA, Park BJ, et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001-2006: Overview of the Transplant-associated infection Surveillance Network (TRANSNET) database[J]. Clin Infect Dis, 2010, 50(8):1091-1100.
[3] Pappas PG, Alexander BD, Andes DR, et al. Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET) [J]. Clin Infect Dis, 2010, 50(8):1101-1111.
[4] Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases[J]. Clin Infect Dis, 2005, 41(5):634-653.
[5] Chayakulkeeree Μ, Perfect JR, Perfect JR. Zygomycosis: the re-emerging fungal infection[J]. Eur J Clin Microbiol Infect Dis, 2006, 25(4): 215-229.
[6] Roilides E, Zaoutis TE, Katragkou A, et al. Zygomycosis in neonates: an uncommon but life-threatening infection[J]. Am J Perinatol, 2009, 26(8):565-573.
[7] Marty FM, Cosimi LA, Baden LR. Breakthrough zygomycosis after voriconazole treatment in recipients of hematopoietic stem-cell transplants[J]. N Engl J Med, 2004, 350(9):950-952.
[8] Ribes JA, Vanover-Sams CL, Baker DJ. Zygomycetes in human disease[J]. Clin Microb Rev, 2000, 13(2): 236-301.
[9] Spellberg B, Walsh TJ, Kontoyiannis DP, et al. Recent advances in the management of mucormycosis: from bench to bedside[J]. Clin Infect Dis, 2009, 48(12): 1743-1751.
[10] Paultauf A. Mycosis mucorina[J]. Arch Path Anat, 1885, 102:543.
[11] Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management[J]. Clin Microbiol Rev, 2005, 18(3):556-569.
[12] Kontoyiannis DP, Lewis RE. Invasive zygomycosis: update on pathogenesis, clinical manifestations, and management[J]. Infect Dis Clin North Am, 2006, 20(3):581-607.
[13] Kontoyiannis DP, Lewis RE. Agents of mucormycosis and related species[M]//Mandell GL, Bennett JE, Dolin R, et al. Principles and Practice of Infectious Diseases (6th ed), Vol 2. Philadelphia, PA: Elsevier Churchill Livingstone. 2005:2973.
[14] Kontoyiannis DP, Lionakis MS, Lewis RE, et al. Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy: acase-control observational study of 27 recent cases[J]. J Infect Dis, 2005, 191(8):1350-1360.
[15] Rüping MJ, Heinz WJ, Kindo AJ, et al. Forty-one recent cases of invasive zygomycosis from a global clinical registry[J]. J Antimicrob Chemother, 2010, 65(2): 296-302.
[16] Skiada A, Pagano L, Groll A, et al. Zygomycosis in Europe: Analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007[J]. Clin Microbiol infect, 2011, 17(12): 1859-1867.
[17] 蒋晓芳,包鸿元,刘振坚,等,胃毛霉菌感染10例报告[J]..实用内科杂志,1985,5(6):316.
[18] 朱继良,胃毛霉菌感染性溃疡5例报告[J].临床误诊误治,1994,7(5):217-218.
[19] Tedder M, Spratt JA, Anstadt MP, et al.Pulmonary mucormycosis:results of medical and surgical therapy[J].Ann Thorac Surg,1994,57(4): 1044-1050.
[20] 孙莹,孙文青,赵婷婷,等,肺结核合并肺毛霉菌感染的临床分析[J].临床肺科杂志,2008,13(11):1440-1441.
[21] 余进,万喆,鲁巧云,等.白血病患者伞枝犁头霉感染二例[J].中华检验医学杂志,2010,33(2):173-174.
[22] McNulty JS. Rhinocerebral mucormycosis: predisposing factors[J]. Laryngoscope, 1982, 92(10 Pt 1):1140-1143.
[23] 吴璇,许庚,文卫平,等.侵袭性鼻脑毛霉菌病的临床研究[J].J Clin Otorhinolaryngol Head Neck Surg(China),2008,22(23):1060-1061.
[24] 王毓新,耿素英,周兵,等.小孢根霉引起鼻脑毛霉菌病2例[J].中华实用医学,2003,5(9):66-67.
[25] 张鲁东,张文夏,邹音.新生儿深部毛霉菌病八例分析[J].中华儿科杂志,2005,43(1):62-64.
[26] Straatsma BR, Zimmerman LE and M.Gass JD. Phycomycosis:a clinicopathologic study of fifty-one cases[J]. Lab Invest, 1962, 11:963-985.
[27] Alvare E, Sutton DA, Cano J, et al. Spectrum of Zygomycete Species Identified in Clinically Significant Specimens in the United States[J]. J Clin Microbiol, 2009, 47(6): 1650-1656.
[28] Kontoyiannis DP, Wessel VC, Bodey GP, et al. Zygomycosis in the 1990s in a tertiary-care cancer center[J]. Clin Infect Dis, 2000, 30(6):851-856.
[29] Kontoyiannis DP, Chamilos G, Hassan SA, et al. Increased culture recovery of Zygomycetes under physiologic temperature conditions[J]. Am J Clin Pathol, 2007, 127(2):208-212.
[30] Chakrabarti A, Kumar P, Padhye AA, et al. Primary cutaneous zygomycosis due to Saksenaea vasiformis and Apophysomyces elegans[J]. Clin Infect Dis, 1997, 24(4):580-583.
[31] Pritchard RC, Muir DB, Archer KH, et al. Subcutaneous zygomycosis due to Saksenaea vasiformis in an infant[J]. Med J Aust, 1986, 145(11-12): 630-631.
[32] Tomford JW, Whittlessey D, Ellner JJ, et al. Invasive primary cutaneous phycomycosis in diabetic leg ulcers[J]. Arch. Surg, 1980, 115(6):770-771.
[33] Eng RHK, Person A, Mangura C, et al. Susceptibility of zygomycetes to amphotericin B, miconazole, and ketoconazole. Antimicrob[J]. Agents Chemother, 1981, 20(5):688-690.
[34] Otcenasek M, and Buchta V. In vitro susceptibility to 9 antifungal agents of 14 strains of Zygomycetes isolated from clinical specimens[J]. Mycopathologia, 1994, 128(3):135-137.
[35] St-Germain G, Robert A, Ishak M, et al. Infection due to Rhizomucor pusillus: report of four cases in patients with leukemia and review[J]. Clin Infect Dis, 1993, 16(5):640-645.
[36] Almyroudis NG, Sutton DA, Fothergill AW, et al. In vitro susceptibilities of 217 clinical isolates of zygomycetes to conventional and new antifungal agents[J]. Antimicrob Agents Chemother, 2007, 51(7):2587-2590.
[37] Dannaoui E, Meletiadis J, Mouton JW, et al. In vitro susceptibilities of zygomycetes to conventional and new antifungals[J]. J Antimicrob Chemother, 2003, 51(1):45-52.
[38] Torres HA, Hachem RY, Chemaly RF, et al. Posaconazole: a broad-spectrum triazole antifungal[J]. Lancet Infect Dis, 2005, 5(12): 775-785.
[39] Rodríguez, MM, Serena C, Mariné M, et al. Posaconazole Combined with Amphotericin B, an Effective Therapy for a Murine Disseminated Infection Caused by Rhizopus oryzae[J]. Antimicrob Agents Chemother, 2008, 52(10): 3786-3788.
[40] Sun QN, Najvar LK, Bocaneqra R, et al. in vivo Activity of Posaconazole against Mucor spp. in an Immunosuppressed-Mouse Model[J]. Antimicrob Agents Chemother, 2002, 46(7): 2310-2312.
[41] Kontoyiannis DP, Lewis RE. How I treat mucormycosis[J].Blood,2011, 118(5):1216-1224.