Outbreaks of Mucorales and the Species Involved

Understanding Mucormycoses in the Age of “omics”

“…Whole genome sequences are available for 21 of the 27 1 . Rhizopus species are the most common cause, accounting for ∼70% of all cases and are the most common organisms isolated from patients with mucormycosis ( Ribes et al, 2000 ; Roden et al, 2005 ; Spellberg et al, 2005 ; Ibrahim and Kontoyiannis, 2013 ; Gebremariam et al, 2014 ; Walther et al, 2019a ). Mucor spp.…”

Detection and Control of Fungal Outbreaks

“…The dermatophytes cause superficial infections, but also deep infections, and negatively impact the quality of life of ~ 1 billion people worldwide [ 2 – 5 ]. Globally, Aspergillus , Candida , Cryptococcus , Pneumocystis , and Mucorales infections (the ‘big five’) are important causes of fungal morbidity and mortality, primarily affecting immunocompromised hosts [ 2 , 6 , 7 ]. Among these big five, Candida yeasts cause the largest number of infections, with annual estimates of 134 million mucosal infections, as well as 750,000 life-threatening bloodstream infections associated with mortality rates > 40% [ 2 , 8 ].…”

“…This special issue covers several aspects of fungal outbreaks. The use of immunodiagnostic and molecular tests for the detection and control of community and healthcare-associated fungal outbreaks is presented [ 20 ] and specifically reviewed for Mucorales and the unculturable Pneumocystis jirovecii [ 6 , 7 ]. Fungal immunodiagnostic assays can detect either antigens, antibodies or metabolites, and are available in different methodologies, presenting from high laboratory complex complement fixation, to the point-of-care lateral flow assays.…”

“…Despite their rapid progressive growth, they are difficult to diagnose as they cannot be detected by an immunodiagnostic assay, like the BDG assay, and thus culture (often negative), histopathology, imaging, and molecular diagnostics remain the diagnostic arsenal from which to choose. Walther and co-workers identified 32 outbreaks of mucormycosis, the majority ( n = 28) were hospital-acquired and four were community-acquired [ 7 ]. Interestingly, Walther and colleagues observed that only in few outbreaks molecular typing was applied to investigate clonality (see Table 1 in [ 7 ]).…”

“…Walther and co-workers identified 32 outbreaks of mucormycosis, the majority ( n = 28) were hospital-acquired and four were community-acquired [ 7 ]. Interestingly, Walther and colleagues observed that only in few outbreaks molecular typing was applied to investigate clonality (see Table 1 in [ 7 ]). Hence, we can conclude that in the case of a suspected Mucorales outbreak there is much more to explore from a molecular epidemiological point of view.…”