Guemas Emilie, Cassaing Sophie, Malavaud Sandra, Fillaux Judith, Chauvin Pamela, Lelièvre Lucie, Ruiz Stéphanie, Riu Béatrice, Berry Antoine, Iriart Xavier
Department of Parasitology and Mycology, Toulouse University Hospital, 31059 Toulouse, France.
Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, 31024 Toulouse, France.
J Fungi (Basel). 2022 Mar 3;8(3):258. doi: 10.3390/jof8030258.
While COVID-19-associated pulmonary aspergillosis is now well described in developed countries, COVID-19-associated mucormycosis (CAM) has seemed to remain quite rare in Europe. A retrospective study was performed between March 2020 to September 2021 among COVID-19 adult patients in the intensive care unit (ICU) at Toulouse Hospital (Southern France). PCR screening on respiratory samples, which target or Mucorales DNA, were performed, and the number of fungal detections was evaluated monthly during the study period. During the 19 months of the study, 44 (20.3%) COVID-19 ICU patients had a positive PCR for , an overall rate in keeping with the incidence of ICU COVID-19 patients. Ten patients (7.1%) had a positive Mucorales PCR over the same period. Surprisingly, 9/10 had a positive / PCR in August-September 2021, during the fourth Delta SARS-CoV-2 variant wave. Epidemic investigations have identified a probable environmental cause linked to construction works in the vicinity of the ICU (high levels of airborne spores due to the mistaken interruption of preventive humidification and summer temperature). Even if CAM are apparently rare in Europe, a cluster can also develop in industrialised countries when environmental conditions (especially during construction work) are associated with a high number of COVID-19 patients in the ICU.
虽然在发达国家，与新冠病毒相关的肺曲霉病已有充分描述，但与新冠病毒相关的毛霉病（CAM）在欧洲似乎仍然相当罕见。2020年3月至2021年9月间，在法国南部图卢兹医院重症监护病房（ICU）的成年新冠患者中进行了一项回顾性研究。对呼吸道样本进行了针对毛霉目DNA 的PCR筛查，并在研究期间每月评估真菌检测数量。在19个月的研究期间，44名（20.3%）新冠ICU患者的PCR检测呈阳性，总体发生率与ICU新冠患者的发病率相符。同期有10名患者（7.1%）的毛霉目PCR检测呈阳性。令人惊讶的是，在2021年8月至9月，即第四波新冠病毒德尔塔变种流行期间，10名患者中有9名的曲霉/毛霉PCR检测呈阳性。流行病学调查确定了一个可能的环境原因，与ICU附近的建筑工程有关（由于预防性加湿的错误中断和夏季高温导致空气中孢子水平升高）。即使CAM在欧洲显然罕见，但在工业化国家，当环境条件（特别是在建筑工程期间）与ICU中大量新冠患者相关联时，也可能出现聚集性病例。
