Epidemiology and prognostic factors of mucormycosis in France (2012-2022): a cross-sectional study nested in a prospective surveillance programme.

Epidemiology Fungal infection Mucorales Mucormycosis Mucormycosis serum PCR Zygomycosis

Journal

The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707

Informations de publication

Date de publication:
Oct 2024
Historique:
received: 17 04 2024
revised: 05 07 2024
accepted: 11 07 2024
medline: 2 9 2024
pubmed: 2 9 2024
entrez: 2 9 2024
Statut: epublish

Résumé

Mucormycosis is a deadly invasive fungal infection recently included in the WHO priority pathogen list. Here we sought to describe epidemiological trends of mucormycosis in France, and to evaluate factors associated with mortality. From 2012 to 2022, we implemented a nationwide prospective surveillance programme for mucormycosis in France, focusing on epidemiology, species, seasonal variations. Factors associated with 3-month mortality were studied by univariable and multivariable logistic regression. Among 550 cases of mucormycosis, the main underlying conditions were haematological malignancy (HM, 65.1%, 358/550), trauma (8%, 44/550), diabetes (7.5%, 41/550) and solid-organ transplants (6.5%, 36/550). Site of infection was pulmonary in 52.4% (288/550), rhinocerebral in 14.5% (80/550), and cutaneo-articular in 17.1% (94/550). Main species identified were This study reveals major mucormycosis epidemiological changes in France, with a large predominance of HM patients, and a parallel between PCR multicentre implementation and improved prognosis. We also evidence new associations between species, localisations and risk factors, as well as seasonal variations. Recurrent financial support from Santé Publique France and Institut Pasteur.

Sections du résumé

Background UNASSIGNED
Mucormycosis is a deadly invasive fungal infection recently included in the WHO priority pathogen list. Here we sought to describe epidemiological trends of mucormycosis in France, and to evaluate factors associated with mortality.
Methods UNASSIGNED
From 2012 to 2022, we implemented a nationwide prospective surveillance programme for mucormycosis in France, focusing on epidemiology, species, seasonal variations. Factors associated with 3-month mortality were studied by univariable and multivariable logistic regression.
Findings UNASSIGNED
Among 550 cases of mucormycosis, the main underlying conditions were haematological malignancy (HM, 65.1%, 358/550), trauma (8%, 44/550), diabetes (7.5%, 41/550) and solid-organ transplants (6.5%, 36/550). Site of infection was pulmonary in 52.4% (288/550), rhinocerebral in 14.5% (80/550), and cutaneo-articular in 17.1% (94/550). Main species identified were
Interpretation UNASSIGNED
This study reveals major mucormycosis epidemiological changes in France, with a large predominance of HM patients, and a parallel between PCR multicentre implementation and improved prognosis. We also evidence new associations between species, localisations and risk factors, as well as seasonal variations.
Funding UNASSIGNED
Recurrent financial support from Santé Publique France and Institut Pasteur.

Identifiants

DOI: 10.1016/j.lanepe.2024.101010 PMID: 39220434 PMC: PMC11363841
pubmed: 39220434
doi: 10.1016/j.lanepe.2024.101010
pii: S2666-7762(24)00177-7
pmc: PMC11363841
doi:

Types de publication

Journal Article

Langues

eng

Pagination

101010

Informations de copyright

© 2024 The Author(s).

Déclaration de conflit d'intérêts

SC reports travel grants for congresses for Gilead and Pfizer. GD reports being a speaker for Gilead. LM reports personal travel grants for Gilead and Pfizer. FL reports being a speaker for MSD and F2G board. AA reports educational lecture and travel grant from Gilead. Other authors declare no competing interests.

Auteurs

Laura Gouzien (L)

Institut Pasteur, Paris Cité University, National Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Paris, France.
Intensive Care Unit, Centre Hospitalier de Versailles, Le Chesnay, France.

Didier Che (D)

Sante Publique France, France.

Sophie Cassaing (S)

Department of Parasitology and Mycology, CHU Toulouse, Restore Institute, Toulouse, France.

Olivier Lortholary (O)

Institut Pasteur, Paris Cité University, National Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Paris, France.
Paris Cité University, Necker-Enfants Malades University Hospital, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), France.

Valérie Letscher-Bru (V)

Parasitology and Medical Mycology Laboratory, Plateau Technique de Microbiologie, Strasbourg University Hospitals, Strasbourg, France.
Institute of Parasitology and Tropical Pathology, UR 3073 Pathogens-Host-Arthropods-Vectors Interactions, Strasbourg University, Strasbourg, France.

Olivier Paccoud (O)

Paris Cité University, Necker-Enfants Malades University Hospital, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), France.

Thomas Obadia (T)

Institut Pasteur, Paris Cité University, National Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Paris, France.
Institut Pasteur, Bioinformatics and Biostatistics Hub, Université Paris Cité, Paris 75015, France.

Florent Morio (F)

Nantes University, CHU Nantes, Cibles et Médicaments des Infections et de l'Immunité, UR1155, Nantes, France.

Maxime Moniot (M)

Parasitology-Mycology Department, Biology Center, Hôpital Gabriel Montpied, Clermont-Ferrand, France.

Estelle Cateau (E)

Mycology Laboratory, CHU de Poitiers, UMR CNRS 7267, Poitiers, France.

Marie Elisabeth Bougnoux (ME)

Parasitology-Mycology Laboratory, AP-HP, Hôpital Necker, Paris, France.
Unité Biologie et Pathogénicité Fongiques, Institut Pasteur, Paris Cité INRAE University, Paris, France.

Taieb Chouaki (T)

Mycology-Parasitology, CHU d'Amiens, Amiens, France.

Lilia Hasseine (L)

Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire de Nice, Nice, France.

Guillaume Desoubeaux (G)

Parasitology-Mycology-Tropical Medecine, Hôpital Bretonneau, Tours, France.
Centre d'Etude des Pathologies Respiratoires - Inserm UMR1100, Medecine Univeristy, Tours, France.

Cecile Gautier (C)

Institut Pasteur, Paris Cité University, National Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Paris, France.

Caroline Mahinc-Martin (C)

Mycology Parasitology Department, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France.

Antoine Huguenin (A)

Reims Champagne Ardenne University, ESCAPE EA7510, Reims, France.
Parasitology-Mycology Laboratory, Pôle de Biologie Pathologie, CHU de Reims, Reims, France.

Julie Bonhomme (J)

Parasitology-Mycology Department, CHU Caen, ToxEMAC-ABTE, Université de Normandie Unicaen, France.

Karine Sitbon (K)

Institut Pasteur, Paris Cité University, National Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Paris, France.

Julien Durand (J)

Sante Publique France, France.

Alexandre Alanio (A)

Institut Pasteur, Paris Cité University, National Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Paris, France.
Parasitology-Mycology Laboratory, AP-HP, Hôpital Saint-Louis, Paris, France.

Laurence Millon (L)

Parasitology-Mycology Department, Besançon University Hospital, Besançon, France.
Chrono-environnement UMR6249, CNRS, Franche-Comté University, Besançon F-25000, France.

Dea Garcia-Hermoso (D)

Institut Pasteur, Paris Cité University, National Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Paris, France.

Fanny Lanternier (F)

Institut Pasteur, Paris Cité University, National Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Paris, France.
Paris Cité University, Necker-Enfants Malades University Hospital, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), France.

Classifications MeSH