A Comparative Analysis of Mucormycosis in Solid Organ Transplant Recipients and Other Immunosuppressed Hosts Including Patients with Uncontrolled Diabetes
1Internal Medicine / Division of Infectious Diseases, University of Arizona, Tucson, AZ, 2Internal Medicine / Division of Infectious Diseases, Banner University Medical Center, Tucson, AZ, 3Internal Medicine, Banner University Medical Center, Tucson, AZ, 4Department of Otolaryngology, University of Arizona, Tucson, AZ
Meeting: 2020 American Transplant Congress
Abstract number: D-159
Keywords: Fungal infection, Infection
Session Information
Session Name: Poster Session D: All Infections (Excluding Kidney & Viral Hepatitis)
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Mucormycosis is a rare disease that is associated with a high morbidity and mortality. It usually affects those with uncontrolled diabetes mellitus (DM) and immunosuppressed patients. We evaluated the characteristics and outcomes of Mucormycosis among Solid Organ Transplant (SOT) recipients and other populations at risk at our center.
*Methods: We conducted an IRB approved single-center retrospective study from January 2009 to January 2019. We included patients greater than 17 years of age with the diagnosis of Mucormycosis. We collected laboratory/microbiology, imaging, histopathological, and clinical outcomes data in order to compare the different groups.
*Results: We identified 23 patients with pulmonary, rhino-orbital-cerebral, and thoracic Mucormycosis. All patients had radiological, histopathological, and clinical manifestations of Mucormycosis. The median age was 54-years and the majority of patients were male (14/23). Our cohort included six SOT recipients (2 hearts and four kidneys), two with hematological malignancies, and 15 with diabetes mellitus as the main risk factor. 4/6 SOT had documented diabetes. Hemoglobin A1C median was lower in the SOT compared to DM only population (6.6 vs 11.6). Eighteen patients had rhino-orbital-cerebral, four had pulmonary, and one had retrosternal involvement. The majority (20) of patients underwent emergent surgical intervention and 21 received liposomal amphotericin B as part of the antifungal regimen. Nine patients received an echinocandin as a component of their antifungal regimen. Twelve patients received isavuconazole, and nine posaconazole. The majority of the patients received adjunctive empirical antibiotic therapy. Seventeen patients received antibiotics active against gram-negative and anaerobic bacteria, while 19 received gram-positive bacterial active antibiotics. A total of 5 patients died during the study period, including one in the SOT and 4 in the DM only group.
*Conclusions: The majority of patients received broad-spectrum antibiotics and antifungal agents. Mucormycosis was associated with a 22% mortality at our center which is lower than previously reported in the literature. Our mortality outcome was similar in the SOT compared to non-SOT group; however, larger and prospective studies are needed in the future.
To cite this abstract in AMA style:
Zangeneh T, Bardwell J, Bouzigard R, Youssefi B, Le C, Al-Obaidi M. A Comparative Analysis of Mucormycosis in Solid Organ Transplant Recipients and Other Immunosuppressed Hosts Including Patients with Uncontrolled Diabetes [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/a-comparative-analysis-of-mucormycosis-in-solid-organ-transplant-recipients-and-other-immunosuppressed-hosts-including-patients-with-uncontrolled-diabetes/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress