Special Issue "Mucorales and Mucormycosis"

A special issue of Journal of Fungi (ISSN 2309-608X).

Deadline for manuscript submissions: 31 March 2019

Special Issue Editors

Guest Editor
Dr. Eric Dannaoui

Université Paris-Descartes, Faculté de Médecine, APHP, Hôpital Européen Georges Pompidou, Unité de Parasitologie-Mycologie, Service de Microbiologie, Paris, France
Website | E-Mail
Interests: clinical microbiology; fungal infection; antifungal susceptibility testing
Guest Editor
Dr. Michaela Lackner

Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
Website | E-Mail
Interests: human pathogenic fungi; antifungal resistance; diagnostic microbiology

Special Issue Information

Dear Colleagues,

Mucormycosis is a worldwide-distributed, life-threatening disease with increasing prevalence. More than 20 species, belonging to several genera, may be responsible for Mucormycosis. Although the disease is recognized for more than a century, many aspects concerning Mucormycosis and Mucorales remains poorly known. The taxonomy of this group of fungi has been largely revised during the past few years with many newly described species and reclassifications. The ecology is not well understood, particularly the prevalence of the different species in the various environmental niches. The disease incidence is also evolving with an increase frequency in immunocompromized patients and the occurrence in special situations such as natural disasters. Epidemiology is also variable depending on the geographical areas. Mucorales are known for their resistance to many antifungal drugs, therefore new drugs and new therapeutic strategies are needed. Moreover, we aim to provide a comprehensive overview on animal models to study these emerging fungal pathogens.

The aim of this Special Issue is to give an up-to-date picture of Mucorales and Mucormycosis through comprehensive reviews, but original studies are also welcome.

Dr. Eric Dannaoui
Dr. Michaela Lackner
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Fungi is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 350 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mucorales
  • mucormycosis
  • ecology
  • taxonomy
  • epidemiology
  • identification
  • resistance
  • treatment

Published Papers (5 papers)

View options order results:
result details:
Displaying articles 1-5
Export citation of selected articles as:

Research

Jump to: Review

Open AccessArticle In Vitro and In Vivo Evaluation of Voriconazole-Containing Antifungal Combinations against Mucorales Using a Galleria mellonella Model of Mucormycosis
J. Fungi 2019, 5(1), 5; https://doi.org/10.3390/jof5010005
Received: 2 December 2018 / Revised: 22 December 2018 / Accepted: 6 January 2019 / Published: 8 January 2019
PDF Full-text (2450 KB) | HTML Full-text | XML Full-text
Abstract
Mucorales are resistant to most antifungals. Mucormycosis associated mortality is unacceptable and new treatment approaches are needed. The objectives of this work were (i) to evaluate the nature and intensity of the in vitro effect of three drugs combinations which included voriconazole (plus [...] Read more.
Mucorales are resistant to most antifungals. Mucormycosis associated mortality is unacceptable and new treatment approaches are needed. The objectives of this work were (i) to evaluate the nature and intensity of the in vitro effect of three drugs combinations which included voriconazole (plus amphotericin B, posaconazole and caspofungin) against 25 strains of six different Mucorales species; (ii) to evaluate a Galleria mellonella mucormycosis model; and (iii) to establish if any in vitro–in vivo correlation exists. As expected, amphotericin B and posaconazole were the most active drugs when tested alone. However, species-specific differences were found. The ΣFICs varied according to the used combination. Only five strains showed synergism when voriconazole was combined with posaconazole and three strains when combined with amphotericin B. Microscopic hyphae alteration were observed for some isolates when confronted against drugs combinations. Using a Galleria mellonella mucormycosis model, better survival was seen in voriconazole plus amphotericin B and plus caspofungin combined treatments when compared with AMB alone for R. microsporus. These survival improvements were obtained using a 32-fold lower amphotericin B doses when combined with VRC than when treated with the polyene alone. These lower antifungal doses emulate the antifungal concentrations where the microscopic hyphae alterations were seen. Full article
(This article belongs to the Special Issue Mucorales and Mucormycosis)
Figures

Figure 1

Review

Jump to: Research

Open AccessReview Global Epidemiology of Mucormycosis
J. Fungi 2019, 5(1), 26; https://doi.org/10.3390/jof5010026 (registering DOI)
Received: 11 February 2019 / Revised: 14 March 2019 / Accepted: 16 March 2019 / Published: 21 March 2019
PDF Full-text (859 KB) | HTML Full-text | XML Full-text
Abstract
Mucormycosis is an angio-invasive fungal infection, associated with high morbidity and mortality. A change in the epidemiology of mucormycosis has been observed in recent years with the rise in incidence, new causative agents and susceptible population. The rise has been perceived globally, but [...] Read more.
Mucormycosis is an angio-invasive fungal infection, associated with high morbidity and mortality. A change in the epidemiology of mucormycosis has been observed in recent years with the rise in incidence, new causative agents and susceptible population. The rise has been perceived globally, but it is very high in the Asian continent. Though diabetes mellitus overshadow all other risk factors in Asia, post-tuberculosis and chronic renal failure have emerged as new risk groups. The rhino-cerebral form of mucormycosis is most commonly seen in patients with diabetes mellitus, whereas, pulmonary mucormycosis in patients with haematological malignancy and transplant recipients. In immunocompetent hosts, cutaneous mucormycosis is commonly seen following trauma. The intriguing clinical entity, isolated renal mucormycosis in immunocompetent patients is only reported from China and India. A new clinical entity, indolent mucormycosis in nasal sinuses, is recently recognized. The causative agents of mucormycosis vary across different geographic locations. Though Rhizopus arrhizus is the most common agent isolated worldwide, Apophysomyces variabilis is predominant in Asia and Lichtheimia species in Europe. The new causative agents, Rhizopus homothallicus, Mucor irregularis, and Thamnostylum lucknowense are reported from Asia. In conclusion, with the change in epidemiology of mucormycosis country-wise studies are warranted to estimate disease burden in different risk groups, analyse the clinical disease pattern and identify the new etiological agents. Full article
(This article belongs to the Special Issue Mucorales and Mucormycosis)
Figures

Figure 1

Open AccessReview Mucormycosis in Burn Patients
J. Fungi 2019, 5(1), 25; https://doi.org/10.3390/jof5010025 (registering DOI)
Received: 7 February 2019 / Revised: 19 March 2019 / Accepted: 20 March 2019 / Published: 21 March 2019
PDF Full-text (241 KB) | HTML Full-text | XML Full-text
Abstract
Patients with extensive burns are an important group at risk for cutaneous mucormycosis. This study aimed to perform a systematic review of all reported mucormycosis cases in burn patients from 1990 onward. A Medline search yielded identification of 7 case series, 3 outbreaks, [...] Read more.
Patients with extensive burns are an important group at risk for cutaneous mucormycosis. This study aimed to perform a systematic review of all reported mucormycosis cases in burn patients from 1990 onward. A Medline search yielded identification of 7 case series, 3 outbreaks, and 25 individual cases reports. The prevalence reached 0.04%–0.6%. The median age was 42–48 in the case series and outbreaks, except for the studies from military centers (23.5–32.5) and in individual reports (29.5). The median total body surface area reached 42.5%–65%. Various skin lesions were described, none being pathognomonic: the diagnosis was mainly reached because of extensive necrotic lesions sometimes associated with sepsis. Most patients were treated with systemic amphotericin B or liposomal amphotericin B, and all underwent debridement and/or amputation. Mortality reached 33%–100% in the case series, 29%–62% during outbreaks, and 40% in individual cases. Most patients were diagnosed using histopathology and/or culture. Mucorales qPCR showed detection of circulating DNA 2–24 days before the standard diagnosis. Species included the main clinically relevant mucorales (i.e., Mucor, Rhizopus, Absidia/Lichtheimia, Rhizomucor) but also more uncommon mucorales such as Saksenaea or Apophysomyces. Contact with soil was reported in most individual cases. Bandages were identified as the source of contamination in two nosocomial outbreaks. Full article
(This article belongs to the Special Issue Mucorales and Mucormycosis)
Open AccessReview Molecular Strategies to Diagnose Mucormycosis
J. Fungi 2019, 5(1), 24; https://doi.org/10.3390/jof5010024
Received: 2 February 2019 / Revised: 14 March 2019 / Accepted: 18 March 2019 / Published: 20 March 2019
PDF Full-text (206 KB) | HTML Full-text | XML Full-text
Abstract
Molecular techniques have provided a new understanding of the epidemiology of mucormycosis and improved the diagnosis and therapeutic management of this life-threatening disease. PCR amplification and sequencing were first applied to better identify isolates that were grown from cultures of biopsies or bronchalveolar [...] Read more.
Molecular techniques have provided a new understanding of the epidemiology of mucormycosis and improved the diagnosis and therapeutic management of this life-threatening disease. PCR amplification and sequencing were first applied to better identify isolates that were grown from cultures of biopsies or bronchalveolar lavage samples that were collected in patients with Mucorales infection. Subsequently, molecular techniques were used to identify the fungus directly from the infected tissues or from bronchalveolar lavage, and they helped to accurately identify Mucorales fungi in tissue samples when the cultures were negative. However, these tools require invasive sampling (biospsy, bronchalveolar lavage), which is not feasible in patients in poor condition in Hematology or Intensive Care units. Very recently, PCR-based procedures to detect Mucorales DNA in non-invasive samples, such as plasma or serum, have proved successful in diagnosing mucormycosis early in all patients, whatever the clinical status, and these procedures are becoming essential to improving patient outcome. Full article
(This article belongs to the Special Issue Mucorales and Mucormycosis)
Figures

Graphical abstract

Open AccessReview Disease Entities in Mucormycosis
J. Fungi 2019, 5(1), 23; https://doi.org/10.3390/jof5010023
Received: 29 January 2019 / Revised: 9 March 2019 / Accepted: 11 March 2019 / Published: 14 March 2019
PDF Full-text (1882 KB) | HTML Full-text | XML Full-text
Abstract
Mucormycosis is an emerging life-threatening fungal infection caused by Mucorales. This infection occurs mainly in immunocompromised patients, especially with hematological malignancy, transplantation, or diabetes mellitus. Rhino-orbito-cerebral and pulmonary mucormycosis are the predominant forms. Interestingly, location is associated with the underlying disease as [...] Read more.
Mucormycosis is an emerging life-threatening fungal infection caused by Mucorales. This infection occurs mainly in immunocompromised patients, especially with hematological malignancy, transplantation, or diabetes mellitus. Rhino-orbito-cerebral and pulmonary mucormycosis are the predominant forms. Interestingly, location is associated with the underlying disease as pulmonary mucormycosis is more frequent in hematological malignancy patients whereas rhino-orbito-cerebral mucormycosis is associated with diabetes. Cutaneous mucormycosis results from direct inoculation, mainly after trauma or surgery. Gastro-intestinal mucormycosis occurs after ingestion of contaminated food or with contaminated device and involves the stomach or colon. Disseminated disease is the most severe form and is associated with profound immunosuppression. Uncommon presentations with endocarditis, osteoarticluar or isolated cerebral infections are also described. Finally, health-care associated mucormycosis is a matter of concern in premature newborns and burn units. Clinical symptoms and CT scan findings are not specific, only the early reversed halo sign is associated with pulmonary mucormycosis. Circulating Mucorales DNA detection is a recent promising diagnostic tool that may lead to improving the diagnosis and prompting therapeutic initiation that should include antifungal treatment, correction of the underlying disease and surgery when feasible. Full article
(This article belongs to the Special Issue Mucorales and Mucormycosis)
Figures

Figure 1

J. Fungi EISSN 2309-608X Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top