Absence of COVID-19 associated mucormycosis in a tertiary intensive care unit in the Netherlands

Abstract Mucormycosis is a severe complication in critically ill COVID-19 patients. Throughout the pandemic, a notable prevalence of mucormycosis has been observed in the Indian population, whereas lower occurrences have been reported in Europe. However, limited data exist regarding its prevalence in Europe, which is potentially underestimated due to the low sensitivity of bronchoalveolar lavage (BAL) cultures. We aimed to evaluate the prevalence of mucormycosis in a high-risk critically ill COVID-19 population in the Netherlands, and to evaluate the potential benefit of adding Mucor PCR to BA... Mehr ...

Verfasser: Schippers, J. R.
Verweij, P. E.
Heunks, L. M. A.
van Dijk, K.
Nossent, Esther J.
Duitman, JanWillem
Saris, Anno
De Vries, Heder
Meijboom, Lilian J.
Bos, Lieuwe D. J.
Blok, Siebe G.
Schuurman, Alex R.
Reijnders, Tom D. Y.
Vallejo, Juan J. Garcia
Bontkes, Hetty
Vlaar, Alexander P. J.
Wiersinga, W. Joost
Lutter, René
van der Poll, Tom
Bogaard, Harm Jan
Heunks, Leo
Zhang, Shiqi
Kullberg, Robert F. J.
de Brabander, Justin
Boers, Leonoor S.
Dokumenttyp: Artikel
Erscheinungsdatum: 2023
Reihe/Periodikum: Scientific Reports ; volume 13, issue 1 ; ISSN 2045-2322
Verlag/Hrsg.: Springer Science and Business Media LLC
Schlagwörter: Multidisciplinary
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27236757
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1038/s41598-023-47231-4

Abstract Mucormycosis is a severe complication in critically ill COVID-19 patients. Throughout the pandemic, a notable prevalence of mucormycosis has been observed in the Indian population, whereas lower occurrences have been reported in Europe. However, limited data exist regarding its prevalence in Europe, which is potentially underestimated due to the low sensitivity of bronchoalveolar lavage (BAL) cultures. We aimed to evaluate the prevalence of mucormycosis in a high-risk critically ill COVID-19 population in the Netherlands, and to evaluate the potential benefit of adding Mucor PCR to BAL as part of routine follow-up. In this study, we included 1035 critically ill COVID-19 patients admitted to either one of the two ICUs at AmsterdamUMC between March 2020 and May 2022; of these, 374 had undergone at least one bronchoscopy. Following the AmsterdamUMC protocols, bronchoscopies were conducted weekly until clinical improvement was achieved. We cultured BAL fluid for fungi and used PCR and galactomannan testing to detect Aspergillus spp. Additionally, we retrospectively performed qPCR targeting Mucorales DNA in the BAL of 89 deceased patients. All cultures were negative for Mucorales, whereas 42 (11%) cultures were positive for Aspergillus . Furthermore, qPCR targeting Mucorales was negative in all 89 deceased patients. This study showed that pulmonary mucormycosis was not present in critically ill COVID-19 patients in two tertiary care ICUs. These results indicate routine Mucorales qPCR screening is not clinically necessary in a high-standard-of-care tertiary ICU in a low-endemic area.