Pham David, Howard-Jones Annaleise R, Sparks Rebecca, Stefani Maurizio, Sivalingam Varsha, Halliday Catriona L, Beardsley Justin, Chen Sharon C-A
Centre for Infectious Diseases & Microbiology, Westmead Hospital, Westmead, NSW 2170, Australia.
Centre for Infectious Diseases & Microbiology Laboratory Services, NSW Health Pathology-Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW 2170, Australia.
J Fungi (Basel). 2023 Jun 12;9(6):659. doi: 10.3390/jof9060659.
Mucormycosis is an uncommon, yet deadly invasive fungal infection caused by the Mucorales moulds. These pathogens are a WHO-assigned high-priority pathogen group, as mucormycosis incidence is increasing, and there is unacceptably high mortality with current antifungal therapies. Current diagnostic methods have inadequate sensitivity and specificity and may have issues with accessibility or turnaround time. Patients with diabetes mellitus and immune compromise are predisposed to infection with these environmental fungi, but COVID-19 has established itself as a new risk factor. Mucorales also cause healthcare-associated outbreaks, and clusters associated with natural disasters have also been identified. Robust epidemiological surveillance into burden of disease, at-risk populations, and emerging pathogens is required. Emerging serological and molecular techniques may offer a faster route to diagnosis, while newly developed antifungal agents show promise in preliminary studies. Equitable access to these emerging diagnostic techniques and antifungal therapies will be key in identifying and treating mucormycosis, as delayed initiation of therapy is associated with higher mortality.
毛霉病是一种由毛霉目霉菌引起的罕见但致命的侵袭性真菌感染。这些病原体是世界卫生组织指定的高优先级病原体组，因为毛霉病的发病率正在上升，并且目前的抗真菌治疗存在不可接受的高死亡率。当前的诊断方法灵敏度和特异性不足，并且在可及性或周转时间方面可能存在问题。糖尿病和免疫功能低下的患者易感染这些环境真菌，但2019冠状病毒病已成为一个新的风险因素。毛霉目还会导致医疗保健相关的疫情爆发，并且与自然灾害相关的聚集性病例也已被发现。需要对疾病负担、高危人群和新出现的病原体进行强有力的流行病学监测。新出现的血清学和分子技术可能提供一条更快的诊断途径，而新开发的抗真菌药物在初步研究中显示出前景。公平获得这些新出现的诊断技术和抗真菌治疗将是识别和治疗毛霉病的关键，因为治疗延迟与更高的死亡率相关。
