Progress of research on prevention and control of mucormycosis

Mucormycosis is an invasive disease caused by Mucorales fungi, which is typically seen in immunocompromised group. The incidence rate can reach 1.2 per million population, with mortality rate ranging between 40% and 80%. Since the second wave of COVID-19 in India, the incidence of COVID-19 associated mucormycosis has been increased significantly worldwide. Humans are infected mainly by inhaling airborne Mucorales spores, and occasionally by ingestion of contaminated food or traumatic wound exposure. The major factors that increase the risk of mucormycosis include hematologic malignancy, diabetes mellitus, hematopoietic stem cell transplant or solid organ transplant recipients. Mucormycosis can be divided into five major clinical types: rhino-orbital-cerebral type, pulmonary type, cutaneous type, gastrointestinal type, and disseminated type. The diagnostic methods include imaging, histopathological examination, fungal culture and polymerase chain reaction. The major measures to prevent the Mucorales infection include treatment and management, monitoring of hospital environment and personal safety maintenance. It is necessary to regularly monitor the blood glucose, avoid the activities that may cause trauma and the transmission of Mucorales spores via air and skin, and maintain personal hygiene. It is crucial for the management of mucormycosis to carry out the early diagnosis, correct the underlying predisposing factors, conduct the surgical debridement for infected tissues and perform appropriate antifungal therapy. The prognosis of the patients may benefit more from the control of diabetes mellitus, reduction of dosage of immunosuppressors, correction of acidosis, recovery of neutrophils, early surgical intervention and amphotericin B.