Zygomycosis

Convenor(s):

George Petrikkos
Anna Skiada (askiada@yahoo.com)
Livio Pagano
Eric Dannaoui
Oliver Cornely
Emmanuel Cuenca-Estrella
Marcio Nucci
Arunaloke Chakrabarti
Theoklis Zaoutis
Tom Walsh

Website: http://www.zygomyco.net/

Overview

Although often described as a rare fungal infection, mucormycosis appears to be increasing in frequency. This has been attributed to the growth of the number of severely immunocompromised patients, as well as to the rising prevalence of diabetes mellitus. Differences in the epidemiology seem to exist depending on geography. In Europe and USA, the disease remains uncommon and is mostly seen in patients with hematological malignancies. In contrast, in Asia, especially in India, mucormycosis is more common, and cases occur mostly in patients with uncontrolled diabetes mellitus or trauma. It mainly affects immunocompromised patients, such as those with haematological malignancies, recipients of haematopoietic stem cell or solid organ transplants, patients with diabetes mellitus, and infants with prematurity. Mucormycosis may also affect immunocompetent patients with trauma or burns, or patients with elevated serum levels of iron under treatment with deferroxamine. Due to the relative rarity of the disease it is difficult to perform stringent epidemiological studies to estimate its exact incidence. Most of the available data stem from case series and pertain to haematological patients or to patients who have undergone transplantation. Taking into consideration the challenges related to epidemiology, treatment and outcome of mucormycosis, a Working Group on Zygomycosis was formed by the European Confederation of Medical Mycology (ECMM). The aim of the group was to analyze the clinical characteristics, microbiology, treatment practices and outcome of mucormycosis in Europe through a voluntary case registry. The results of the first 3 years (2005–2007) were published in 2011. In 2008 the Working Group became global, under the auspices of both ECMM and ISHAM (Ιnternational Society for Human and Animal Mycology).

 

Objectives:

The aim of this registry is to collect as many cases of mucormycosis as possible from all around the world, in order to better understand the various aspects of this rare disease.
Further aims of the group are:
1. To collect strains of mucoraceous moulds for state-of-the-art molecular identification and long-term maintenance. Strains will thus have official accession-numbers which can be used in future publications.
2. To collect any available histology specimen for PCR. This will aid in the identification of fungi when no cultures are available, as well as for comparison with culture proven strains.

Achievements

The WG continued its activities during 2015-2016.

Two hundred and eighty cases have been submitted to the Zygomycosis registry (www.zygomyco.net)

A round table was organized at the ISHAM Congress in Melbourne, entitled: Mucormycosis: Past, Present and Future. The speakers were Anna Skiada, Arunaloke Chakrabarti, Monica Slavin and Tom Walsh.

An analysis of the pediatric cases of mucormycosis, collected by our group, has been performed and published.

A manuscript entitled “Development of new strategies for early diagnosis of mucormycosis from bench to bedside" presenting the new protocol proposal has been published in Mycoses.

Publications

Pana et al.  Invasive mucormycosis in children: an epidemiologic study in European and non- European countries based on two registries. BMC Infectious Diseases (2016) 16:667 (Link here to the article)

Walsh et al. Development of new strategies for early diagnosis of mucormycosis from bench to bedside. Mycoses (2014) 57: Supp 3 :2-7 (Link here to the article)