What is the prevalence of mucormycosis (zygomycosis) in the United States and globally??

Updated: Jul 06, 2021
  • Author: Avnish Sandhu, DO; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Mucormycosis is rare, and its incidence is difficult to calculate accurately. Further, since mucormycosis is not a reportable disease, the true incidence is unknown. An estimated burden of mucormycosis in United States is 3.0 cases per 1 million people, increased from 1.75 cases per 1 million people in the United States annually. [23, 24, 25]  A retrospective study among 560 hospitals with 104 million patients, estimated the prevalence of mucormycosis related hospitalizations at 0.12 per 10,000 discharges. [26, 25] .A prospective surveillance for invasive fungal infections conducted at 23 transplant centers from 2001-2006, reported an incidence of 0.29% for hematopoietic stem cell transplant and 0.07% for solid organ transplant. [25, 26]  A rise in mucormycosis incidence was seen in patients with hematological malignancy per 100 autopsies, from 0.006 cases (1989-1993) to 0.018 cases in (2004-2008). [25, 27]

The incidence of mucormycosis appears to be increasing secondary to rising numbers of immunocompromised persons. There are also increasing reports of breakthrough mucormycosis in the setting of antifungal prophylaxis or treatment (eg, voriconazole, echinocandins) that is effective against most fungi, such as Aspergillus, but not mucormycosis. With improvements in early diagnosis via modalities such as matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF), polymerase chain reaction (PCR), and 18s rRNA sequencing, it has been suggested that mucormycosis is the cause of more than 10% of invasive fungal infections. [28, 29]

Additionally, several cases of cutaneous mucormycosis due to the Mucormycete Apophysomyces trapezi­formis were described among wound-injured victims from a tornado. [18, 30, 31]

A rise in mucormycosis cases have been seen globally, the estimate of mucormycosis rose to 910,000 cases globally. [32, 33, 25]  Increased cases were noted in Asia and Europe. A multicenter study from Spain estimating prevalence of mucormycosis, reported 0.43 cases per million population/year. [34, 25]  Similarly, a population based study conducted nation-wide in France, reported an increase in prevalence in 1997 to 2006, 0.7 cases to 1.2 per million cases; respectively. [25, 35] A single centre study from India reported a rise in mucormycosis cases from 24.7 cases to 89 cases per year. [25, 36]  A study conducted in multiple ICUs in India, reported high burden of mucormycosis, it was detected in 14.4% of patients. [25, 37]


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