Epidemiology and clinical outcomes of invasive mould infections in Indian intensive care units (FISF study)

Chakrabarti, Arunaloke; Kaur, Harsimran; Savio, Jayanthi; Rudramurthy, Shivaprakash M.; Patel, Atul; Shastri, Prakash; Umabala, P; Karthik, Rajiv; Bhattacharya, Sanjay; Kindo, Anupma Jyoti; Bhattacharya, Pradip; Todi, Subhash; Gopalakrishan, Ram; Singh, Meenu; Pandey, Abhishek; Agarwal, Ritesh

doi:10.1016/j.jcrc.2019.02.005

Cited by 72 publications

(49 citation statements)

References 31 publications

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“…A recent study from India reported a rise of mucormycosis cases from 24.7 cases per year (1990–2007) to 89 cases per year (2013–2015) at a single tertiary-care hospital [5]. In a multicentre study from Indian ICUs, mucormycosis has been reported at 24% of all invasive mould infections [20]. Dolatabadi et al from Iran reported a rising trend of mucormycosis from 9.7% in 2008 to 23.7% in 2014 [21].…”

Section: Incidence Of Mucormycosismentioning

confidence: 99%

“…It is claimed that regular statin use in diabetic patients has brought down diabetes as a risk factor for mucormycosis in the United States [68], though a case series from the same country reported diabetes as risk factor in 52% cases of mucormycosis [14]. Diabetes has also been reported as an important risk factor in Iran (74%) and Mexico (72%) [20,69]. In comparison to other regions, this risk factor is lower in European studies ranged from 17% to 29%: 17% in European Confederation of Medical Mycology (ECMM) study [11]; 23% in RetroZygo Study of France [70], 18% in Italy [71], 29% in Greece [72].…”

Section: Underlying Disease/predisposing Factorsmentioning

confidence: 99%

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Global Epidemiology of Mucormycosis

Prakash

Chakrabarti

2019

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Mucormycosis is an angio-invasive fungal infection, associated with high morbidity and mortality. A change in the epidemiology of mucormycosis has been observed in recent years with the rise in incidence, new causative agents and susceptible population. The rise has been perceived globally, but it is very high in the Asian continent. Though diabetes mellitus overshadow all other risk factors in Asia, post-tuberculosis and chronic renal failure have emerged as new risk groups. The rhino-cerebral form of mucormycosis is most commonly seen in patients with diabetes mellitus, whereas, pulmonary mucormycosis in patients with haematological malignancy and transplant recipients. In immunocompetent hosts, cutaneous mucormycosis is commonly seen following trauma. The intriguing clinical entity, isolated renal mucormycosis in immunocompetent patients is only reported from China and India. A new clinical entity, indolent mucormycosis in nasal sinuses, is recently recognized. The causative agents of mucormycosis vary across different geographic locations. Though Rhizopus arrhizus is the most common agent isolated worldwide, Apophysomyces variabilis is predominant in Asia and Lichtheimia species in Europe. The new causative agents, Rhizopus homothallicus, Mucor irregularis, and Thamnostylum lucknowense are reported from Asia. In conclusion, with the change in epidemiology of mucormycosis country-wise studies are warranted to estimate disease burden in different risk groups, analyse the clinical disease pattern and identify the new etiological agents.

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Section: Incidence Of Mucormycosismentioning

confidence: 99%

Section: Underlying Disease/predisposing Factorsmentioning

confidence: 99%

Global Epidemiology of Mucormycosis

Prakash

Chakrabarti

2019

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“…Climatic and geographic conditions may be important determinants of the local prevalence and distribution of Aspergillus species. A. flavus is more prevalent in the environment of some tropical countries like India, Mexico, Pakistan, Sudan, and Saudi Arabia and consequently remains the most frequent species causing aspergillosis in those countries [9,10,11,12,13,14]. To understand the reason for this differential geographical distribution of Aspergillus species, further studies on underlying biological attributes of different Aspergillus species are warranted.…”

Section: Clinical Spectrum and Distributionmentioning

confidence: 99%

“…Recently, Chakrabarti et al conducted a multicentric study on invasive mold infection in Indian ICUs and reported Aspergillus (47%— A. flavus vs. 39.4%— A. fumigatus ) as the most common fungus isolated from patients with non-classical risk factors (63.5%) surpassing the classical risk factors (36.4%) [13]. More recently, it has been observed that IA can develop concurrently with severe influenza in apparently immunocompetent individuals [13,15,16,17]. In a series of 18 cases of influenza associated aspergillosis (IAA) from China, A. flavus was implicated in three patients (17%), two survived, and one expired [17].…”

Section: Clinical Spectrum and Distributionmentioning

confidence: 99%

“…In a series of 18 cases of influenza associated aspergillosis (IAA) from China, A. flavus was implicated in three patients (17%), two survived, and one expired [17]. In the multicentric study on ICU acquired mold infection from India, 142 cases of invasive aspergillosis were observed of which 12 (8.5%) cases were IAA and half of those were due to A. flavus [13]. A. flavus is associated with sino-orbital aspergillosis and ocular infection, especially in developing countries [5].…”

Section: Clinical Spectrum and Distributionmentioning

confidence: 99%

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Invasive Aspergillosis by Aspergillus flavus: Epidemiology, Diagnosis, Antifungal Resistance, and Management

Rudramurthy

Paul

Chakrabarti

et al. 2019

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Aspergillus flavus is the second most common etiological agent of invasive aspergillosis (IA) after A. fumigatus. However, most literature describes IA in relation to A. fumigatus or together with other Aspergillus species. Certain differences exist in IA caused by A. flavus and A. fumigatus and studies on A. flavus infections are increasing. Hence, we performed a comprehensive updated review on IA due to A. flavus. A. flavus is the cause of a broad spectrum of human diseases predominantly in Asia, the Middle East, and Africa possibly due to its ability to survive better in hot and arid climatic conditions compared to other Aspergillus spp. Worldwide, ~10% of cases of bronchopulmonary aspergillosis are caused by A. flavus. Outbreaks have usually been associated with construction activities as invasive pulmonary aspergillosis in immunocompromised patients and cutaneous, subcutaneous, and mucosal forms in immunocompetent individuals. Multilocus microsatellite typing is well standardized to differentiate A. flavus isolates into different clades. A. flavus is intrinsically resistant to polyenes. In contrast to A. fumigatus, triazole resistance infrequently occurs in A. flavus and is associated with mutations in the cyp51C gene. Overexpression of efflux pumps in non-wildtype strains lacking mutations in the cyp51 gene can also lead to high voriconazole minimum inhibitory concentrations. Voriconazole remains the drug of choice for treatment, and amphotericin B should be avoided. Primary therapy with echinocandins is not the first choice but the combination with voriconazole or as monotherapy may be used when the azoles and amphotericin B are contraindicated.

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Difficulties Faced in Asian Countries for the Diagnosis of Fungal Infections and Possible Solutions

Chakrabarti

2019

Clinical Practice of Medical Mycology in Asia

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Epidemiology and clinical outcomes of invasive mould infections in Indian intensive care units (FISF study)

Cited by 72 publications

References 31 publications

Global Epidemiology of Mucormycosis

Global Epidemiology of Mucormycosis

Invasive Aspergillosis by Aspergillus flavus: Epidemiology, Diagnosis, Antifungal Resistance, and Management

Difficulties Faced in Asian Countries for the Diagnosis of Fungal Infections and Possible Solutions

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