Incidence of zygomycosis in transplant recipients

Abstract

Recently, a remarkable increase in the incidence of zygomycosis has been reported from institutions in the USA and Europe. The use of voriconazole for the treatment of aspergillosis and, less frequently, the use of echinocandins as empirical treatment for invasive fungal infections are thought to be responsible for the increase. In addition, an increased incidence of this infection has been observed in transplant recipients, including both haematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) patients. There are no global surveys on the prevalence or incidence of zygomycosis, but data from individual institutions and countries show that zygomycosis is an emerging infection. The increased incidence of zygomycosis most probably reflects a greater frequency of predisposing factors, such as higher numbers of patients undergoing HSCT and immunosuppressive chemotherapy. In addition, the emergence of rare pathogens as a result of the rise in the use of antifungal therapy against common species can be postulated. Further, the availability of antifungal agents with activity profiles that are more specific for selected fungi increases the necessity of identifying pathogenic fungi; the frequency of Zygomycetes infections may have been underestimated until now because therapeutic decisions did not depend on the precise identification of pathogenic fungi.

Mucormycosis in renal transplant recipients: review of 174 reported cases

“…Although there are some studies focus on the epidemiology and risk factors of mucormycosis in solid organ transplant recipients [11, 12], this is the first critical review of the epidemiology, diagnosis, and treatment of mucormycosis in RT patients. We find that the incidence of mucormycosis in RT patients was growing within the past several decades.…”

Stability in the cumulative incidence, severity and mortality of 101 cases of invasive mucormycosis in high‐risk patients from 1995 to 2011: a comparison of eras immediately before and after the availability of voriconazole and echinocandin‐amphotericin combination therapies

“…No fluconazole was used as prophylaxis in AML cases. The separation of the 17‐year interval in this study, into two eras to assess a prevoriconazole era vs. a postvoriconazole era, that is, 1995–2003 for era 1 and 2004–2011 for era 2, also aligns well with another similar analysis which had analysed published reports from 1970 to 2005 and compared those to published reports from 2006 to 2008, to assess voriconazole effects in transplant populations.…”

Usefulness of molecular biology performed with formaldehyde-fixed paraffin embedded tissue for the diagnosis of combined pulmonary invasive mucormycosis and aspergillosis in an immunocompromised patient

“…Although invasive mycoses have long been recognized for a long time as being caused by significant pathogens, particularly in immunocompromised patients, the frequency of infection with opportunistic fungi is increasing with time and the spectrum of the infectious agent of invasive mycoses is changing [1-4]. In this regard, advances in therapeutic technologies and in particular the development of novel immunosuppressive therapies, have prolonged the period of risk for many individuals [3,4].…”

“…Invasive fungal infections appear to have increased over the past few years, mostly in immunocompromised patient [1-4]. Moreover, the diagnosis of invasive filamentous fungal disease (IFFD) is often difficult in immunodeficient patients.…”