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Mucormycosis-related hospitalizations double since 2000
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Hospitalizations related to invasive aspergillosis and mucormycosis significantly increased between 2000 and 2013, with a doubling of mucormycosis-related hospitalizations, according to findings published in Open Forum Infectious Diseases.
“Because invasive aspergillosis and mucormycosis are not reportable diseases and there is no ongoing surveillance for this infection, no single data source exists to determine the burden of and trends in invasive aspergillosis and mucormycosis in the United States,” Snigdha Vallabhaneni, MD, MPH, of the Centers for Disease Control, Atlanta, Georgia, and colleagues wrote. “However, because most persons with these invasive mold infections require hospitalization, national administrative hospital discharge data can be used to estimate the incidence of invasive aspergillosis and mucormycosis. In addition, hospital discharge data can provide insights into the trends in types of patients developing invasive mold infections by evaluating other discharge diagnoses listed for each hospitalization.”
Researchers used the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project, a database of publicly available all-payer health care information, to estimate hospitalizations related to invasive aspergillosis, mucormycosis hematopoietic stem cell transplantations, hematologic malignancies and solid organ transplants from 2000 to 2013. Vallabhaneni and colleagues then used census data to calculate overall rates of invasive aspergillosis and mucormycosis.
The researchers reported an estimated 169,110 invasive aspergillosis-related hospitalizations and 9,966 mucormycosis-related hospitalizations. Overall rates rose from 32.8 to 46 cases per million for aspergillosis and from 1.7 to 3.4 cases per million for mucormycosis (P < .001 for both). Among stem cell transplantation–related hospitalizations, researchers reported no significant change in mucormycosis hospitalizations, although hospitalizations related to invasive aspergillosis declined (P = .004). Vallabhaneni and colleagues wrote that mucormycosis increased (P < .001) among hematologic malignancy–related hospitalizations, whereas invasive aspergillosis did not significantly change (P = .073). Hospitalizations related to both infections increased among hospitalizations for solid organ transplants (P = .038 for mucormycosis; P < .001 for invasive aspergillosis).
“Overall rates of invasive aspergillosis and mucormycosis-related hospitalizations have increased in the United States since 2000,” the researchers wrote. “Although the incidence of mucormycosis remains several fold lower than that of invasive aspergillosis, mucormycosis is becoming an increasingly important invasive mold infection, especially among highly immunocompromised patients such as those with hematopoietic stem cell transplantations, hematologic malignancies and solid organ transplants. Ongoing surveillance to better understand the true burden of invasive aspergillosis, mucormycosis and other invasive mold infections and strategies for the control of these infections are needed.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.
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