Abstract：
OBJECTIVE: Mucormycosis is an opportunistic fungal infection associated with low incidence but high mortality. Few studies have shown the treatment and disease burden of mucormycosis in China. This study aims at collecting all the reported cases to describe the characteristics and treatment patterns and to assess the economic burden of mucormycosis in China.
METHODS: We conducted a literature review of mucormycosis case reports in Chinese patients to summarize the characteristics and treatment patterns of the disease in China. An economic model was built to evaluate the total cost of mucormycosis per person, including direct medical cost, direct non-medical cost and indirect cost.
CONCLUSIONS: A total of 676 case reports showed that the most common type of mucormycosis was pulmonary mucormycosis (299/676, 44.2%), and rhinocerebral mucormycosis had the highest case fatality rate (122/185, 68.5%). Among those who used empiric therapies, 48.8% (231/473) did not include anti-mucor drugs; 79.8% (336/421) of the therapies include amphotericin B (AMB) or AMB-lipo after detection of mucormycetes; 98.6% (69/70) of the reported adverse events were associated with AMB and AMB-lipo. The duration of treatment ranged from 90 to 180 days; the length of stay ranged from 22 to 95 days. The average total cost per patient was 166 thousand Chinese Yuan (CNY), of which 93.1% was the direct medical cost (155 thousand CNY).
CONCLUSIONS: There are a limited number of antifungal treatment options for mucormycosis in China. This study highlights the critical need to introduce innovative and broader spectrum antifungal drugs with improved safety, better clinical efficacy, easier administration and reduced economic burden to Chinese mucormycosis patients.
METHODS: We conducted a literature review of mucormycosis case reports in Chinese patients to summarize the characteristics and treatment patterns of the disease in China. An economic model was built to evaluate the total cost of mucormycosis per person, including direct medical cost, direct non-medical cost and indirect cost.
CONCLUSIONS: A total of 676 case reports showed that the most common type of mucormycosis was pulmonary mucormycosis (299/676, 44.2%), and rhinocerebral mucormycosis had the highest case fatality rate (122/185, 68.5%). Among those who used empiric therapies, 48.8% (231/473) did not include anti-mucor drugs; 79.8% (336/421) of the therapies include amphotericin B (AMB) or AMB-lipo after detection of mucormycetes; 98.6% (69/70) of the reported adverse events were associated with AMB and AMB-lipo. The duration of treatment ranged from 90 to 180 days; the length of stay ranged from 22 to 95 days. The average total cost per patient was 166 thousand Chinese Yuan (CNY), of which 93.1% was the direct medical cost (155 thousand CNY).
CONCLUSIONS: There are a limited number of antifungal treatment options for mucormycosis in China. This study highlights the critical need to introduce innovative and broader spectrum antifungal drugs with improved safety, better clinical efficacy, easier administration and reduced economic burden to Chinese mucormycosis patients.
摘要：
目的：毛霉菌病是一种机会性真菌感染，发病率低，死亡率高。很少有研究显示中国毛霉菌病的治疗和疾病负担。这项研究旨在收集所有报告的病例，以描述特征和治疗模式，并评估中国毛霉菌病的经济负担。
方法：我们对中国患者的毛霉菌病病例报告进行了文献综述，以总结该疾病在中国的特点和治疗方式。建立了一个经济模型来评估每人毛霉菌病的总成本，包括直接医疗费用,直接非医疗成本和间接成本。
结论：共有676例病例报告显示，最常见的毛霉菌病类型是肺毛霉菌病（299/676，44.2%），鼻脑毛霉菌病的病死率最高（122/185，68.5％）。在那些使用经验性疗法的人中，48.8%(231/473)不包括抗粘膜药物；79.8%(336/421)的治疗包括两性霉素B(AMB)或AMB-lipo，在检测到粘液菌后；98.6%(69/70)的报告不良事件与AMB和AMB-lipo相关。治疗时间为90至180天；住院时间为22至95天。每位患者的平均总费用为人民币16.6万元，其中93.1%为直接医疗费用(15.5万元人民币)。
结论：在中国，毛霉菌病的抗真菌治疗方案数量有限。这项研究强调了引入创新和更广谱的抗真菌药物以提高安全性的迫切需要。临床疗效较好,更容易给药，减轻了中国毛霉菌病患者的经济负担。
方法：我们对中国患者的毛霉菌病病例报告进行了文献综述，以总结该疾病在中国的特点和治疗方式。建立了一个经济模型来评估每人毛霉菌病的总成本，包括直接医疗费用,直接非医疗成本和间接成本。
结论：共有676例病例报告显示，最常见的毛霉菌病类型是肺毛霉菌病（299/676，44.2%），鼻脑毛霉菌病的病死率最高（122/185，68.5％）。在那些使用经验性疗法的人中，48.8%(231/473)不包括抗粘膜药物；79.8%(336/421)的治疗包括两性霉素B(AMB)或AMB-lipo，在检测到粘液菌后；98.6%(69/70)的报告不良事件与AMB和AMB-lipo相关。治疗时间为90至180天；住院时间为22至95天。每位患者的平均总费用为人民币16.6万元，其中93.1%为直接医疗费用(15.5万元人民币)。
结论：在中国，毛霉菌病的抗真菌治疗方案数量有限。这项研究强调了引入创新和更广谱的抗真菌药物以提高安全性的迫切需要。临床疗效较好,更容易给药，减轻了中国毛霉菌病患者的经济负担。
