Laboratory practices for the diagnosis and management of mucormycosis in France, 2024

J Mycol Med. 2024 Dec;34(4):101520. doi: 10.1016/j.mycmed.2024.101520. Epub 2024 Nov 14.

Abstract

This study investigates the diagnostic practices for mucormycosis among 30 French University Hospital mycology laboratories, in 2024. All laboratories perform both direct examination and culture, with fluorescent brighteners being the most commonly used method for direct examination. While 77 % of the participating laboratories routinely identify Mucorales to the species level, with 70 % having adopted Mucorales-specific quantitative PCR, primarily for the diagnosis of invasive fungal infections. Antifungal susceptibility testing practices varied between centers, with 36.7 % of laboratories consistently performing these tests, primarily using gradient concentration strips. Amphotericin B, posaconazole, and isavuconazole were the most frequently tested antifungals. These findings highlight variations in laboratory practices and emphasize the importance of establishing uniform diagnostic and susceptibility testing methods to optimize mucormycosis management.

Keywords: Laboratory practice; Mucorales; Mucormycosis.

MeSH terms

  • Amphotericin B / therapeutic use
  • Antifungal Agents* / therapeutic use
  • Clinical Laboratory Techniques / methods
  • Clinical Laboratory Techniques / standards
  • France / epidemiology
  • Hospitals, University
  • Humans
  • Laboratories / standards
  • Laboratories, Hospital
  • Microbial Sensitivity Tests*
  • Mucorales* / drug effects
  • Mucorales* / isolation & purification
  • Mucormycosis* / diagnosis
  • Mucormycosis* / drug therapy
  • Mucormycosis* / epidemiology
  • Mucormycosis* / microbiology
  • Mucormycosis* / therapy
  • Nitriles
  • Pyridines
  • Triazoles / therapeutic use

Substances

  • Antifungal Agents
  • Triazoles
  • Amphotericin B
  • isavuconazole
  • Nitriles
  • Pyridines