Badali Hamid, Mohamadi Bahar, Mahmoudi Shahram, Nasirian Maryam, Amiri Siavash, Irani Shirin, Yassin Zeynab, Vaseghi Narges, Alavi Darazam Ilad, Salehi Mohammadreza, Roham Maryam, Abolghasemi Sara, Divsalar Farshad, Hasibi Mehrdad, Hakamifard Atousa, Hashemi Bafghi Maryamosadat, Saberi Simin, Vaezi Afsane
Department of Molecular Microbiology and Immunology/South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, TX, USA.
Department of Microbiology, Tehran North Branch, Islamic Azad University, Tehran, Iran.
Mycopathologia. 2025 Sep 17;190(5):87. doi: 10.1007/s11046-025-00995-x.
Mucormycosis is a rare, destructive, and life-threatening angio-invasive fungal infection caused by fungi of the order Mucorales. This study highlights the urgent need for more extensive research in this regard. We aimed to assess the epidemiology of mucormycosis at eight tertiary-care centers in Iran over ten years (2010-2020).
In the current retrospective study, eligible patients were included based on positive histopathology and direct microscopy by potassium hydroxide (KOH). Data collection started on July 26, 2021, and included data from February 15, 2010, to May 16, 2020.
Diabetes mellitus was the chief underlying condition related to mucormycosis. Rhino-cerebral, rhino-sino, and rhino-sino-orbital infections were observed in 53.2%, 23.8%, and 23% of these patients. Among the 108 cases with a culture, Rhizopus species were the most prevalent, followed by Mucor species. Over half of the patients received surgery/antifungal treatment, with an overall antifungal prescribing rate of 66.7% of patients within the study period. However, surgery was associated with better clinical outcomes than surgery/antifungal treatment. The antifungals prescribed were mainly amphotericin B, posaconazole, and amphotericin-posaconazole. Most patients with mucormycosis infection were admitted in the summer. Overall mortality in the identified cases was 30.6%, with the highest mortality rate in patients diagnosed with pulmonary infection.
The current study is the largest single-country retrospective study on the topic, with 601 mucormycosis cases. It may uncover gaps in knowledge, develop recommendations for future studies, and clarify the clinical and epidemiological aspects of mucormycosis. However, future studies and clarification of mucormycosis's clinical and epidemiological aspects are highly recommended.
毛霉病是一种由毛霉目真菌引起的罕见、具有破坏性且危及生命的血管侵袭性真菌感染。本研究强调了在这方面进行更广泛研究的迫切需求。我们旨在评估伊朗八家三级医疗中心在十年（2010 - 2020年）期间毛霉病的流行病学情况。
在当前这项回顾性研究中，符合条件的患者基于组织病理学阳性以及氢氧化钾（KOH）直接显微镜检查结果纳入研究。数据收集于2021年7月26日开始，涵盖了2010年2月15日至2020年5月16日的数据。
糖尿病是与毛霉病相关的主要基础疾病。在这些患者中，鼻 - 脑型、鼻 - 鼻窦型和鼻 - 鼻窦 - 眼眶型感染分别占53.2%、23.8%和23%。在108例有培养结果的病例中，根霉属最为常见，其次是毛霉属。超过一半的患者接受了手术/抗真菌治疗，在研究期间患者的总体抗真菌药物处方率为66.7%。然而，手术与比手术/抗真菌治疗更好的临床结果相关。所开具的抗真菌药物主要是两性霉素B、泊沙康唑以及两性霉素 - 泊沙康唑。大多数毛霉病感染患者在夏季入院。确诊病例的总体死亡率为30.6%，其中诊断为肺部感染的患者死亡率最高。
本研究是关于该主题的最大规模的单国回顾性研究，有601例毛霉病病例。它可能揭示知识空白，为未来研究提出建议，并阐明毛霉病的临床和流行病学方面。然而，强烈建议未来进行研究并进一步阐明毛霉病的临床和流行病学方面。
