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Mucormycosis in the Middle East and North Africa: Analysis of the FungiScope ® registry and cases from the literature
Author(s) -
Stemler Jannik,
Hamed Kamal,
SalmantonGarcía Jon,
RezaeiMatehkolaei Ali,
Gräfe Stefanie K.,
Sal Ertan,
Zarrouk Marouan,
Seidel Danila,
Abdelaziz Khedr Reham,
BenAmi Ronen,
BenChetrit Eli,
Roth Yehudah,
Cornely Oliver A.
Publication year - 2020
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.13123
Subject(s) - mucormycosis , medicine , immunosuppression , epidemiology , antifungal , mortality rate , diabetes mellitus , surgery , dermatology , endocrinology
Summary Background Regional differences in the underlying causes, manifestations and treatment of mucormycosis have been noted in studies covering Europe, Asia and South America. Objectives To review cases of mucormycosis across the Middle East and North Africa (MENA) region in order to identify epidemiological, treatment and outcome trends in this region. Patients/Methods Cases of proven or probable invasive mucormycosis from the region were identified from the FungiScope ® database and the medical literature. For each case, information on underlying condition, site of infection, pathogenic species, therapeutic intervention, type of antifungal therapy and outcome were analysed. Results We identified 310 cases of mucormycosis in the MENA region. The number of reported cases increased by decade from 23 before 1990 to 127 in the 2010s. In this region, the most common underlying conditions associated with mucormycosis were diabetes mellitus (49.7%) and conditions associated with immunosuppression (46.5%). The majority of patients received treatment with antifungals (93.5%), with a large proportion treated with both antifungals and surgery (70.6%). Overall mortality rates decreased from 47.8% before 1990 to 32.3% in the 2010s. Conclusions The number of reported cases of mucormycosis in the MENA region has risen over the past few decades, in line with increases in the number of patients with underlying conditions associated with this infection. Although the majority of patients received treatment with antifungal therapies and/or surgery, the associated mortality rate remains high and there is a clear need for more effective prevention and treatment strategies in the MENA region.