Survival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI study

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dc.contributor.authorCag, Yasemin
dc.contributor.authorErdem, Hakan
dc.contributor.authorGunduz, Mehmet
dc.contributor.authorKomur, Suheyla
dc.contributor.authorAnkarali, Handan
dc.contributor.authorUral, Serap
dc.contributor.authorTasbakan, Meltem
dc.date.accessioned2024-04-24T16:11:20Z
dc.date.available2024-04-24T16:11:20Z
dc.date.issued2022
dc.departmentDicle Üniversitesien_US
dc.description.abstractBackground: Mucormycosis is an emerging aggressive mold infection. This study aimed to assess the outcome of hospitalized adults with rhino-orbito-cerebral mucormycosis (ROCM). The secondary objective was to identify prognostic factors in this setting. Methods: This study was an international, retrospective, multicenter study. Patients' data were collected from 29 referral centers in 6 countries. All qualified as proven cases according to the EORTC/MSGERC criteria. Results: We included 74 consecutive adult patients hospitalized with ROCM. Rhino-orbito-cerebral type infection was the most common presentation (n = 43; 58.1%) followed by rhino-orbital type (n = 31; 41.9%). Twenty (27%) had acquired nosocomial bacterial infections. A total of 59 (79.7%) patients (16 in combination) received appropriate antifungal treatment with high-doses of liposomal amphotericin B. Fifty-six patients (75.7%) underwent curative surgery. Thirty-five (47.3%) required intensive care unit admission (27; 36.5% under mechanical ventilation). Hospital survival was 56.8%, being reduced to 7.4% in patients with invasive mechanical ventilation. A multivariate binary backward logistic regression model identified confusion at admission (OR 11.48), overlapping hospital-acquired infection (OR 10.27), use of antifungal treatment before diagnosis (OR 10.20), no surgical debridement (OR 5.92), and the absence of prior sinusitis (OR 6.32) were independently associated with increased risk for death. Conclusion: Today, ROCM still has high mortality rate. Improving source control, rational therpy, and preventing nosocomial infections may improve survival in this severe infection.en_US
dc.identifier.doi10.1016/j.ejim.2022.03.008
dc.identifier.endpage61en_US
dc.identifier.issn0953-6205
dc.identifier.issn1879-0828
dc.identifier.pmid35304041
dc.identifier.scopus2-s2.0-85126521600
dc.identifier.scopusqualityQ1
dc.identifier.startpage56en_US
dc.identifier.urihttps://doi.org/10.1016/j.ejim.2022.03.008
dc.identifier.urihttps://hdl.handle.net/11468/15355
dc.identifier.volume100en_US
dc.identifier.wosWOS:000866517600011
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofEuropean Journal of Internal Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectMucormycosisen_US
dc.subjectRhino-Orbito-Cerebral Mucormycosisen_US
dc.subjectRisk Factorsen_US
dc.subjectDebridementen_US
dc.subjectNeutropeniaen_US
dc.subjectHospital-Acquired Infectionen_US
dc.titleSurvival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI studyen_US
dc.titleSurvival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI study
dc.typeArticleen_US

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