Non-Candida mycosis in Gulf Cooperation Council (GCC) countries: perspective of a low-incidence region
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Abdullah AlSaleh1,2, Mohammed Shahid3
1Microbiology, Immunology and Infectious Diseases Dept., College of Medicine and Health Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain. dr.abdullahaas@gmail.com.
Background:
Fungal pathogens are ubiquitous microorganisms that are implicated in a wide range of infections, affecting individuals with underlying health conditions and immune suppression therapy; however, immunocompetent individuals may also be at risk. Among these infections, many are caused by molds and yeasts other than Candida and are recognized in clinical practice, such as aspergillosis, mucormycosis, fusariosis, phaeohyphomycosis, and basidiobolomycosis, among others, each presents different clinical manifestations and requires clinical management specific to the site of involvement. Although pathogenic fungal contaminants and potential sources of mycosis in humans are plentiful in Gulf Cooperation Council (GCC) countries, epidemiological reports regarding mycosis in the region are scarce.
Aim:
The aim of this review is to shed some light on the epidemiology of clinically associated molds and yeasts other than Candida and to survey all related case reports and epidemiological studies conducted in the GCC over the past 10 years.
Methods:
A comprehensive search of the Medline (PubMed) and Scopus databases was conducted using the following keywords: Aspergillosis, Mycosis, Mucormycosis, Fusarium, Kuwait, Bahrain, Saudi Arabia, Qatar, Oman and the United Arab Emirates. A timeframe was set to include only articles that were published from 2014 to 2024.
Results:
One hundred thirty-five of the 1563 articles examined fulfilled the purpose of this review. Most studies were in Saudi Arabia (45%), Qatar (18%) and Kuwait (16%). Mucormycosis, aspergillosis, phaeohyphomycosis and basidiobolomycosis were among the most commonly reported fungal infections in the GCC, with corresponding mortality rates of 53%, 37%, 69% and 24%, respectively. The average estimations of non-Candida fungal infections indicate a low regional incidence in comparison with global estimations.
Conclusion:
Awareness and a high index of suspicion are warranted in successfully managing non-Candida mycosis. More specific immunological and molecular markers are needed for differential diagnosis to rule out fungal infections. Additionally, incorporating non-Candida mycosis-related antifungal resistance surveys in GCC national surveillance efforts should be enforced, especially when considering the increase in global mycosis rates.
Insights
Epidemiological data on non-Candida fungal infections in the Gulf Cooperation Council (GCC) is scarce. This review highlights common fungal pathogens and their mortality rates, emphasizing the need for increased awareness and surveillance.
Area of Science:
- Medical Mycology
- Infectious Diseases Epidemiology
- Public Health Surveillance
Background:
- Fungal pathogens, including molds and yeasts other than Candida, cause significant infections, particularly in immunocompromised individuals.
- Common non-Candida mycoses include aspergillosis, mucormycosis, fusariosis, phaeohyphomycosis, and basidiobolomycosis, each with distinct clinical presentations.
- Despite the prevalence of fungal contaminants in the Gulf Cooperation Council (GCC), regional epidemiological data on mycosis remains limited.
Purpose of the Study:
- To review the epidemiology of clinically relevant molds and yeasts (excluding Candida) in the GCC.
- To survey case reports and epidemiological studies on non-Candida mycoses in the GCC published between 2014 and 2024.
Main Methods:
- A systematic literature search was performed using Medline (PubMed) and Scopus databases.
- Keywords included specific fungal infections (e.g., Aspergillosis, Mucormycosis) and GCC countries (Kuwait, Bahrain, Saudi Arabia, Qatar, Oman, UAE).
- The search was limited to articles published from 2014 to 2024.
Main Results:
- Out of 1563 reviewed articles, 135 met the inclusion criteria.
- Saudi Arabia (45%), Qatar (18%), and Kuwait (16%) were the most studied regions.
- Common infections included mucormycosis (53% mortality), aspergillosis (37% mortality), phaeohyphomycosis (69% mortality), and basidiobolomycosis (24% mortality).
Conclusions:
- Effective management of non-Candida mycoses requires heightened awareness and clinical suspicion.
- Development of specific immunological and molecular markers is crucial for accurate differential diagnosis.
- Antifungal resistance surveillance for non-Candida mycoses should be integrated into GCC national health strategies due to rising global rates.
