Mortality Rate of Mucormycosis and its Risk Factors in Hospitalized Patients in Alzahra Hospital, Isfahan, Iran, during 2011-2015

Document Type : Original Article (s)

Authors

1 Assistant Professor, Infectious Diseases and Tropical Medicine Research Center AND Department of Infectious Diseases and Tropical Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Professor, Infectious Diseases and Tropical Medicine Research Center AND Department of Infectious Diseases and Tropical Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor, Department of Medical Parasitology and Mycology, School of Medicine AND Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Mucormycosis is a rare disease with high mortality rate, especially in immunocompromised patients such as patients with diabetes. This study aimed to evaluate the prevalence of mucormycosis and its association with mortality rate in patients admitted to Alzahra hospital, Isfahan, Iran.Methods: 55 patients with symptomatic and definitive diagnosis of mucormycosis were enrolled in this retrospective cross-sectional study. Mortality risk factors were evaluated and compared between the dead and survived patients.Findings: Mortality rate was 29.09 percent among the patients and there was a significant relationship between the involved location and the mortality rate (P = 0.02). In addition, the mortality rate was 100% in patients with disseminated infections.Conclusion: The mortality rate in patients with mucormycosis admitted to Alzahra hospital was lower than the rates reported by other studies.

Keywords


  1. Kontoyiannis DP, Wessel VC, Bodey GP, Rolston KV. Zygomycosis in the 1990s in a tertiary-care cancer center. Clin Infect Dis 2000; 30(6): 851-6.
  2. Marr KA, Carter RA, Crippa F, Wald A, Corey L. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 2002; 34(7): 909-17.
  3. Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: A review of 929 reported cases. Clin Infect Dis 2005; 41(5): 634-53.
  4. Csomor J, Nikolova R, Sinko J, Remenyi P, Szabo Z. Mucormycosis. Orv Hetil 2004; 145(50): 2507-13. [In Hungarian].
  5. Ibrahim AS, Spellberg B, Avanessian V, Fu Y, Edwards JE, Jr. Rhizopus oryzae adheres to, is phagocytosed by, and damages endothelial cells in vitro. Infect Immun 2005; 73(2): 778-83.
  6. Alvarez-Alvarez C, Rodriguez-Conde I, Hortas-Guldris M, San Miguel-Fraile P. Mucormycosis caused by Rhizopus oryzae in a patient with atypical diabetes. Enferm Infecc Microbiol Clin 2005; 23(9): 576-7. [In Spanish].
  7. Spellberg B, Edwards J, Jr., Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 2005; 18(3): 556-69.
  8. Boelaert JR, de Locht M, Van Cutsem J, Kerrels V, Cantinieaux B, Verdonck A, et al. Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies. J Clin Invest 1993; 91(5): 1979-86.
  9. Chakrabarti A, Dhaliwal M. Epidemiology of mucormycosis in India. Current Fungal Infection Reports 2013; 7(4): 287-92.
  10. Mantadakis E, Samonis G. Clinical presentation of zygomycosis. Clin Microbiol Infect 2009; 15(Suppl 5): 15-20.
  11. Ali S, Ahmad I. Mucormycosis causing palatal necrosis and orbital apex syndrome. J Coll Physicians Surg Pak 2005; 15(3): 182-3.
  12. Spellberg B, Kontoyiannis DP, Fredricks D, Morris MI, Perfect JR, Chin-Hong PV, et al. Risk factors for mortality in patients with mucormycosis. Med Mycol 2012; 50(6): 611-8.
  13. Skiada A, Lanternier F, Groll AH, Pagano L, Zimmerli S, Herbrecht R, et al. Diagnosis and treatment of mucormycosis in patients with hematological malignancies: guidelines from the 3rd European Conference on Infections in Leukemia (ECIL 3). Haematologica 2013; 98(4): 492-504.
  14. Hong HL, Lee YM, Kim T, Lee JY, Chung YS, Kim MN, et al. Risk factors for mortality in patients with invasive mucormycosis. Infect Chemother 2013; 45(3): 292-8.
  15. Frater JL, Hall GS, Procop GW. Histologic features of zygomycosis: emphasis on perineural invasion and fungal morphology. Arch Pathol Lab Med 2001; 125(3): 375-8.
  16. Dabritz J, Attarbaschi A, Tintelnot K, Kollmar N, Kremens B, von Loewenich FD, et al. Mucormycosis in paediatric patients: Demographics, risk factors and outcome of 12 contemporary cases. Mycoses 2011; 54(6): e785-e788.
  17. Lalwani S, Govindasamy M, Gupta M, Siraj F, Varma V, Mehta N, et al. Gastrointestinal mucormycosis--four cases with different risk factors, involving different anatomical sites. Indian J Gastroenterol 2012; 31(3): 139-43.
  18. Lewis RE, Georgiadou SP, Sampsonas F, Chamilos G, Kontoyiannis DP. Risk factors for early mortality in haematological malignancy patients with pulmonary mucormycosis. Mycoses 2014; 57(1): 49-55.
  19. Nateghian AR, Karimi A. Report of 6 cases with rhinocerebral mucormycosis. Feyz 2004; 8(2): 88-96. [In Persian].
  20. Mohammadi R, Nazeri M, Sayedayn SM, Ehteram H. A successful treatment of rhinocerebral mucormycosis due to Rhizopus oryzae. J Res Med Sci 2014; 19(1): 72-4.
  21. Mohammadi R, Meidani M, Mostafavizadeh K, Iraj B, Hamedani P, Sayedain SM, et al. Case series of rhinocerebral mucormycosis occurring in diabetic patients. Caspian J Intern Med 2015; 6(4): 243-6.
  22. Zarrinfar H, Kaboli S, Dolatabadi S, Mohammadi R. Rapid detection of Candida species in bronchoalveolar lavage fluid from patients with pulmonary symptoms. Braz J Microbiol 2016; 47(1): 172-6.
  23. Mohammadi R, Abastabar M, Mirhendi H, Badali H, Shadzi S, Chadeganipour M, et al. Use of restriction fragment length polymorphism to rapidly identify dermatophyte species related to dermatophytosis. Jundishapur J Microbiol 2015; 8(6): e17296.