烧伤毛霉菌病的研究进展

沈拓; 朱峰

doi:10.3760/cma.j.cn501225-20231101-00165

烧伤毛霉菌病的研究进展

doi: 10.3760/cma.j.cn501225-20231101-00165

沈拓¹,
朱峰^2, ,

1.
同济大学附属东方医院重症医学科，上海　　200120
2.
海军军医大学第一附属医院烧伤科，上海　　200433

基金项目:

国家重点研发计划“干细胞及转化研究”重点专项 2019YFA0110602

详细信息

通讯作者:
朱峰，Email：alexzhufeng0816@vip.sina.com

计量
- 文章访问数: 202
- HTML全文浏览量: 83
- PDF下载量: 34
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-01
- 网络出版日期: 2023-12-19

Research progress of mucormycosis in burns

Shen Tuo¹,
Zhu Feng^{2
, ,}

1.
Department of Critical Care Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai 200120, China
2.
Burn Department, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China

Funds:

National Key Research and Development Program "Stem Cell and Transformation Research" Key Special Project 2019YFA0110602

More Information

Corresponding author: Zhu Feng, Email: alexzhufeng0816@vip.sina.com

摘要

摘要: 毛霉菌病是一种相对罕见但危害极大的感染性疾病。烧伤患者尤其是大面积烧伤患者是毛霉菌病的高危人群，近年来毛霉菌病在烧伤患者中的发生率有上升趋势。目前国内关于烧伤毛霉菌病的文献较少，且多为案例报道，而没有系统性总结。基于此，该文结合近年来国内外的相关文献，就烧伤毛霉菌病的流行病学特点、临床表现、诊断及治疗方法进行综述，以期为我国烧伤毛霉菌病的诊断及治疗提供一些依据。
- 烧伤 /
- 侵袭性真菌感染 /
- 毛霉菌病 /
- 诊断 /
- 治疗
Abstract: Mucormycosis is a relatively rare but dangerous infectious diseases. Burn patients, especially severe burn patients, are at high risk of mucormycosis. In recent years, the incidence of mucormycosis in burn patients has increased. At present, there are a few domestic literatures on mucormycosis in burns, with most being case reports without systematic summary. Based on the relevant literature at home and abroad in recent years, this article reviewed the epidemiological characteristics, clinical manifestations, diagnostic methods, and treatment methods of mucormycosis in burns, hoping to provide some basis for the diagnosis and treatment of mucormycosis in burns in China.
- Burns /
- Invasive fungal infections /
- Mucormycosis /
- Diagnosis /
- Treatment
所有作者均声明不存在利益冲突

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参考文献(37)

[1]	SoboutiB, DahmardeheiM, FallahS, et al. Candidemia in pediatric burn patients: risk factors and outcomes in a retrospective cohort study[J]. Curr Med Mycol, 2020, 6(3):33-41. DOI: 10.18502/cmm.6.3.4663.
[2]	DangJ, GoelP, ChoiKJ, et al. Mucormycosis following burn injuries: a systematic review[J]. Burns, 2023,49(1):15-25. DOI: 10.1016/j.burns.2022.05.012.
[3]	FréalleE, RocchiS, BacusM, et al. Real-time polymerase chain reaction detection of Lichtheimia species in bandages associated with cutaneous mucormycosis in burn patients[J]. J Hosp Infect, 2018,99(1):68-74. DOI: 10.1016/j.jhin.2018.02.004.
[4]	FarmerAR, MurrayCK, DriscollIR, et al. Combat-related pythium aphanidermatum invasive wound infection: case report and discussion of utility of molecular diagnostics[J]. J Clin Microbiol, 2015,53(6):1968-1975. DOI: 10.1128/JCM.00410-15.
[5]	HospenthalDR, ChungKK, LairetK, et al. Saksenaea erythrospora infection following combat trauma[J]. J Clin Microbiol, 2011,49(10):3707-3709. DOI: 10.1128/JCM.05095-11.
[6]	DevauchelleP, JeanneM, FréalleE. Mucormycosis in burn patients[J]. J Fungi (Basel), 2019, 5(25):1-12.DOI: 10.3390/jof5010025.
[7]	JeongW, KeighleyC, WolfeR, et al. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports[J]. Clin Microbiol Infect, 2019,25(1):26-34. DOI: 10.1016/j.cmi.2018.07.011.
[8]	LittlehalesE, TeagueR, AndrewD, et al. Mucormycosis in burns: a review[J]. J Burn Care Res, 2022,43(2):353-360. DOI: 10.1093/jbcr/irab236.
[9]	MitchellTA, HardinMO, MurrayCK, et al. Mucormycosis attributed mortality: a seven-year review of surgical and medical management[J]. Burns, 2014,40(8):1689-1695. DOI: 10.1016/j.burns.2014.03.013.
[10]	RibeiroNF, HeathCH, KierathJ, et al. Burn wounds infected by contaminated water: case reports, review of the literature and recommendations for treatment[J]. Burns, 2010,36(1):9-22. DOI: 10.1016/j.burns.2009.03.002.
[11]	ChristiaensG, HayetteMP, JacqueminD, et al. An outbreak of Absidia corymbifera infection associated with bandage contamination in a burns unit[J]. J Hosp Infect, 2005,61(1):88. DOI: 10.1016/j.jhin.2004.12.011.
[12]	BakerRD. Pulmonary mucormycosis[J]. Am J Pathol,1956,32(2):287-313.
[13]	FoleyFD, ShuckJM3rd, FishbeinMC, et al. Burn-wound infection with phycomycetes requiring amputation of hand[J]. JAMA, 1968, 203(8):596. DOI: 10.1001/jama.1968.03140080056017.
[14]	Garcia-HermosoD, CriscuoloA, LeeSC, et al. Outbreak of invasive wound mucormycosis in a burn unit due to multiple strains of Mucor circinelloides f. circinelloides resolved by whole-genome sequencing[J]. mBio, 2018, 9(2):e00573-18. DOI: 10.1128/mBio.00573-18.
[15]	SchaalJV, LeclercT, SolerC, et al. Epidemiology of filamentous fungal infections in burned patients: a French retrospective study[J]. Burns, 2015,41(4):853-863. DOI: 10.1016/j.burns.2014.10.024.
[16]	ReidG, LynchJP, FishbeinMC, et al. Mucormycosis[J]. Semin Respir Crit Care Med, 2020,41(1):99-114. DOI: 10.1055/s-0039-3401992.
[17]	SatiH, BeardsleyJ, Alastruey-IzquierdoA, et al. WHO fungal priority pathogens list to guide research development and public health[M]. Geneva: World Health Organization,2022. DOI: 10.13140/RG.2.2.31126.63040.
[18]	李峰,杨红明,王宏伟.烧伤患者毛霉菌侵袭性感染(附4例报告)并文献复习[J/CD].中华损伤与修复杂志(电子版), 2011, 6(3):3.DOI: 10.3877/cma.j.issn.1673-9450.2011.03.012.
[19]	SteinbrinkJM, MiceliMH. Mucormycosis[J]. Infect Dis Clin North Am, 2021,35(2):435-452. DOI: 10.1016/j.idc.2021.03.009.
[20]	CornelyOA, Alastruey-IzquierdoA, ArenzD, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium[J]. Lancet Infect Dis, 2019,19(12):e405-e421. DOI: 10.1016/S1473-3099(19)30312-3.
[21]	VenkateshD, DandagiS, ChandrappaPR, et al. Mucormycosis in immunocompetent patient resulting in extensive maxillary sequestration[J]. J Oral Maxillofac Pathol, 2018,22(Suppl 1):S112-116. DOI: 10.4103/jomfp.JOMFP_163_17.
[22]	SkiadaA, Lass-FloerlC, KlimkoN, et al. Challenges in the diagnosis and treatment of mucormycosis[J]. Med Mycol, 2018,56(Suppl_1):S93-101. DOI: 10.1093/mmy/myx101.
[23]	ChermetzM, GobboM, RupelK, et al. Combined orofacial aspergillosis and mucormycosis: fatal complication of a recurrent paediatric glioma-case report and review of literature[J]. Mycopathologia, 2016, 181(9/10):723-733. DOI: 10.1007/s11046-016-0021-8.
[24]	DhaliwalHS, SinghA, SinhaSK, et al. Diagnosed only if considered: isolated renal mucormycosis[J]. Lancet, 2015,385(9984):2322. DOI: 10.1016/S0140-6736(15)60730-9.
[25]	KungVL, ChernockRD, BurnhamCD. Diagnostic accuracy of fungal identification in histopathology and cytopathology specimens[J]. Eur J Clin Microbiol Infect Dis, 2018,37(1):157-165. DOI: 10.1007/s10096-017-3116-3.
[26]	MiceliMH, MaertensJ. Role of non-culture-based tests, with an emphasis on galactomannan testing for the diagnosis of invasive aspergillosis[J]. Semin Respir Crit Care Med, 2015, 36(5):650-661. DOI: 10.1055/s-0035-1562892.
[27]	DonnellyJP, ChenSC, KauffmanCA, et al. Revision and update of the consensus definitions of invasive fungal disease from the European organization for research and treatment of cancer and the mycoses study group education and research consortium[J]. Clin Infect Dis, 2020, 71(6):1367-1376. DOI: 10.1093/cid/ciz1008.
[28]	ChamilosG, MaromEM, LewisRE, et al. Predictors of pulmonary zygomycosis versus invasive pulmonary aspergillosis in patients with cancer[J]. Clin Infect Dis, 2005,41(1):60-66. DOI: 10.1086/430710.
[29]	HammerMM, MadanR, HatabuH. Pulmonary mucormycosis: radiologic features at presentation and over time[J]. AJR Am J Roentgenol, 2018, 210(4):742-747. DOI: 10.2214/AJR.17.18792.
[30]	JungJ, KimMY, LeeHJ, et al. Comparison of computed tomographic findings in pulmonary mucormycosis and invasive pulmonary aspergillosis[J]. Clin Microbiol Infect, 2015,21(7):684.e11-e18. DOI: 10.1016/j.cmi.2015.03.019.
[31]	IbrahimAS, SpellbergB, WalshTJ, et al. Pathogenesis of mucormycosis[J]. Clin Infect Dis, 2012,54(Suppl 1):S16-22. DOI: 10.1093/cid/cir865.
[32]	AkersKS, RowanMP, NieceKL, et al. Antifungal wound penetration of amphotericin and voriconazole in combat-related injuries: case report[J]. BMC Infect Dis, 2015,15:184. DOI: 10.1186/s12879-015-0918-8.
[33]	LedgardJP, van HalS, GreenwoodJE. Primary cutaneous zygomycosis in a burns patient: a review[J]. J Burn Care Res, 2008,29(2):286-290. DOI: 10.1097/BCR.0b013e31816673b1.
[34]	RodriguezCJ, TribbleDR, MaloneDL, et al. Treatment of suspected invasive fungal infection in war wounds[J]. Mil Med, 2018,183(Suppl_2):S142-146. DOI: 10.1093/milmed/usy079.
[35]	WarkentienT, RodriguezC, LloydB, et al. Invasive mold infections following combat-related injuries[J]. Clin Infect Dis, 2012,55(11):1441-1449. DOI: 10.1093/cid/cis749.
[36]	KontoyiannisDP, LewisRE. How I treat mucormycosis[J]. Blood, 2011,118(5):1216-1224. DOI: 10.1182/blood-2011-03-316430.
[37]	MariaNC, PimjaiN. Deferiprone as adjunctive treatment for patients with invasive mucormycosis: a retrospective case series[J]. Infectious Disease Reports, 2018,10(2):7765. DOI: 10.4081/idr.2018.7765.

1 烧伤毛霉菌病（鼻眶脑型毛霉菌病除外）诊断流程

注：MRI为磁共振成像

下载: 全尺寸图片幻灯片

2 烧伤毛霉菌病推荐治疗方案

注：两性霉素B脂质体特指进口品牌；流程中的推荐强度是参照2019年毛霉菌病诊断和管理全球指南^[20]做出的，本文目前仅对两性霉素B脂质体、泊沙康唑和艾沙康唑有推荐强度

下载: 全尺寸图片幻灯片