title: Mucormycete infection or colonisation: experience of an Australian tertiary referral centre.
abstract: Mucormycosis is associated with significant morbidity and mortality. We reviewed patients with mucormycete isolated at Alfred Health, Australia. A retrospective review of 66 patients with mucormycete(s) identified, between 1 April 2008 and 30 June 2014. Baseline demographic, microbiological, radiological, treatment/outcome data were recorded. Site of isolation was sinopulmonary in 77% and skin/soft tissue in 21%. A total of 32% of cases were proven-IFD, 12% probable-IFD and 56% were defined as no-IFD (or colonisation). Rhizopus spp. was identified in 48%. Comparing probable/proven-IFD with no-IFD/colonisation, more patients were postallogeneic stem cell transplantation (28% vs. 0%, P < 0.01) and were receiving immunosuppressive therapy (59% vs. 24%, P < 0.01) including prednisolone >20 mg daily (24% vs. 5%, P = 0.04). A total of 93% of patients with proven/probable IFD received treatment while 30% of no-IFD/colonisation were treated. A total of 72% of patients with proven/probable IFD and 92% of those with colonisation had no further mucormycete isolated. Thirty day mortality was higher in the proven/probable-IFD cohort (24%) compared with no-IFD/colonisation (3%) (P = 0.02). Mucormycosis remains uncommon, with 56% of cases not associated with clinical infection. Immunosuppressive therapy remains strongly associated with mucormycosis. Mortality remains high in those with proven/probable IFD.
authors: Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia.
authors: S
authors: S
authors: Langford
authors: Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia.|Department of Microbiology, Alfred Health and Monash University, Melbourne, Vic., Australia.
authors: J A
authors: JA
authors: Trubiano
authors: Department of Pathology, Alfred Health, Melbourne, Vic., Australia.
authors: S
authors: S
authors: Saxon
authors: Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia.|Department of Microbiology, Alfred Health and Monash University, Melbourne, Vic., Australia.
authors: D
authors: D
authors: Spelman
authors: Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Vic., Australia.
authors: C O
authors: CO
authors: Morrissey
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009090:Mucorales / Q000145:classification* / Q000302:isolation & purification; D009091:Mucormycosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D010256:Paranasal Sinuses / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000382:microbiology; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000401:mortality; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014739:Victoria / Q000453:epidemiology
keywords: Invasive fungal disease; mucormycete; mucormycosis; transplant; zygomycosis