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Invasive Mould Infections Following Combat-Related Injuries-A Retrospective Cohort Study
Tomer Hoffman1,2, Yael Haviv2,3, Amir Cohen2,3
1Infectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel.
Mycoses
|February 4, 2025
Summary
Invasive mould infections (IMIs) following combat wounds are rare but severe. Manogepix showed high in-vitro activity, suggesting potential for treating these difficult-to-manage infections.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Combat Medicine
Background:
- Limited data exists on invasive mould infections (IMIs) in combat-related wounds.
- Understanding these infections is crucial for improving casualty care.
Purpose of the Study:
- To characterize the clinical features and outcomes of IMIs in recent conflict casualties.
- To evaluate antifungal susceptibility, including the novel agent manogepix.
Main Methods:
- Retrospective study of hospitalized patients with combat injuries and wound-related IMIs.
- Analysis of patient demographics, injury types, IMI management, and outcomes.
- Reporting of mould isolates, susceptibility testing, and manogepix activity.
Main Results:
- 31 patients (1.9% incidence) developed IMIs, predominantly from blast injuries.
- Aspergillus and Fusarium species were common, with high non-susceptibility to azoles and amphotericin B.
- Manogepix demonstrated good in-vitro activity against most isolates, except Mucorales.
Conclusions:
- Combat wound-related IMIs are uncommon but associated with significant morbidity and mortality.
- Manogepix shows promise due to high susceptibility rates.
- Further research on surgical management and antifungal susceptibility testing is warranted.
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