Abstract：
The second wave of coronavirus disease 2019 (COVID-19), during the early 2021, lead to a devastating outbreak of mucormycosis in India. This study aimed to determine the aetiology, clinical features, comorbidities, and risk factors of rhino-orbito-cerebral mucormycosis (ROCM) and antifungal susceptibility pattern for the isolates. The study included all suspected cases of ROCM in post-COVID-19 patients attending the hospital from May to December 2021. A total of 70 patients were diagnosed with mucormycosis during the study period. The commonest presentations were rhino-orbital and rhino-orbito-cerebral in 35.7% of cases each. Diabetes mellitus was the commonest associated risk factor in 95.7% of all patients, while 78.5% of the patients were treated with corticosteroids in the recent past, and 25.7% presented with active COVID-19 pneumonia. The commonest isolate was Rhizopus arrhizus n = 14, followed by Aspergillus flavus n = 16, A. fumigatus n = 4, A. niger n = 3, Fusarium oxysporumn = 1, and Apophysomyces variabilisn = 1. Fungal species identification was done by phenotypic methods for all the isolates and DNA sequence analysis of 18 isolates, and antifungal susceptibility testing of 30 isolates was performed by commercially prepared HiMIC plate (HiMedia, Mumbai, India) using broth microdilution for amphotericin B, isavuconazole, itraconazole, voriconazole, and posaconazole. The MIC50 and MIC90 of amphotericin B for R. arrhizus strains were 0.25 and 4 μg/ml, respectively; and the MIC50 and MIC90 results for itraconazole, posaconazole, and isavuconazole were 8 and 8, 2 and 2, and 2 and 8 μg/ml, respectively. In vitro data showed that amphotericin B was the most effective antifungal against most species. The commercially available ready-to-use minimum inhibitory concentration plates are user-friendly for performing antifungal susceptibility, which may be useful in choosing appropriate regimens and monitoring emerging resistance.
摘要：
2019年第二波冠状病毒病（COVID-19），在2021年初，导致印度毛霉菌病的毁灭性爆发。本研究旨在确定病因，临床特征,犀牛-流-脑毛霉菌病（ROCM）的合并症和危险因素以及分离物的抗真菌药敏模式。该研究包括2021年5月至12月在COVID后住院的所有ROCM疑似病例-19患者。在研究期间，有70例患者被诊断为毛霉菌病。最常见的表现是犀牛眼眶和犀牛眼眶，各占35.7%。糖尿病（DM）是95.7％的患者中最常见的相关危险因素，而78.5％的患者最近接受了皮质类固醇治疗。25.7%出现活动性COVID-19肺炎。最常见的分离株是阿氏根霉n=14，其次是黄曲霉n=16，烟曲霉n=4，黑曲霉n=3，尖孢镰刀菌n=1，变形杆菌n=1。通过表型方法对所有分离株进行真菌种类鉴定，并对18个分离株进行DNA序列分析，并通过商业制备的HiMIC平板（HiMedia，孟买,印度）使用肉汤微量稀释两性霉素B，伊沙武康唑,伊曲康唑,伏立康唑和泊沙康唑.两性霉素B的MIC50和MIC90分别为0.25和4μg/ml；伊曲康唑的MIC50和MIC90结果，泊沙康唑,异戊唑醇分别为8和8、2和2、2和8μg/ml，分别。体外数据表明，两性霉素B是针对大多数物种的最有效的抗真菌药。市售的即用型MIC板对于进行抗真菌易感性是用户友好的,其可用于选择合适的方案和监测新出现的抗性。
本研究旨在提高读者对与COVID-19相关的真菌感染问题的认识，这种真菌感染通常在病程后期被诊断出来。
本研究旨在提高读者对与COVID-19相关的真菌感染问题的认识，这种真菌感染通常在病程后期被诊断出来。
