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Healthcare-associated mucormycosis
Blandine Rammaert1, Fanny Lanternier, Jean-Ralph Zahar
1Sorbonne Paris Cité, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, APHP, Université Paris-Descartes, Centre d'Infectiologie Necker-Pasteur, 149 rue de Sèvres, Paris Cedex 15, France.
Summary
Healthcare-associated mucormycosis is a severe fungal infection linked to medical procedures and devices. Investigations are crucial, especially in vulnerable patient groups like neonates and transplant recipients.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Public Health
Background:
- Mucormycosis is a severe, emerging invasive fungal infection.
- Healthcare-associated mucormycosis arises from environmental exposure during medical procedures.
- This review focuses on cases linked to healthcare procedures between 1970 and 2008.
Purpose of the Study:
- To review and analyze cases of healthcare-associated mucormycosis.
- To identify risk factors, common sites of infection, and causative agents.
- To highlight the importance of thorough investigation in specific units.
Main Methods:
- Exhaustive review of mucormycosis cases meeting EORTC/MSG 2008 criteria.
- Analysis of 169 cases, including patient demographics and underlying conditions.
- Examination of infection localization, microbiological, and histological findings.
Main Results:
- 169 cases studied: 29% children, 61% male. Common underlying diseases: solid organ transplantation (24%), diabetes mellitus (22%), severe prematurity (21%).
- Most common site: skin (57%), followed by gastrointestinal tract (15%). Rhizopus was the most frequent genus (43%).
- Infection portals included surgery and medical devices. Outbreaks linked to bandages, tongue depressors, ostomy bags, and water systems.
Conclusions:
- Healthcare-associated mucormycosis is a significant concern, particularly in neonatology, hematology, and transplantation units.
- Prompt and thorough investigations are mandatory to identify and manage these infections.
- Understanding transmission routes, including contaminated medical devices and environmental factors, is critical for prevention.
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