TY - JOUR
T1 - Disease burden and demographic characteristics of mucormycosis
T2 - A nationwide population-based study in Taiwan, 2006–2017
AU - Shih, Hsin I.
AU - Huang, Yi Ting
AU - Wu, Chi Jung
N1 - Funding Information:
This work was funded by the Ministry of Science and Technology of Taiwan (grant numbers MOST 108‐2314‐B‐400‐031‐MY3 and MOST 110‐2625‐M‐006‐009) and National Cheng Kung University Hospital (grant no. NCKUH‐11103007).
Publisher Copyright:
© 2022 The Authors. Mycoses published by Wiley-VCH GmbH.
PY - 2022/11
Y1 - 2022/11
N2 - Background: Epidemiological knowledge of mucormycosis obtained from national population-based databases is scarce. Objectives: This study aimed to depict the disease burden and demographics of mucormycosis in Taiwan by using the Taiwan National Health Insurance Research Database (NHIRD) and those of aspergillosis as a comparator. Methods: Data from patients with either mucormycosis or aspergillosis from 2006 to 2017 identified with the International Classification of Diseases (ICD) codes were extracted from the NHIRD. The incidence, demographics and clinical data of both diseases were analysed. Results: A total of 204 patients with mucormycosis and 2270 patients with aspergillosis who were hospitalised and treated with mould-active antifungals between 2006 and 2017 were identified. The average annual incidence of aspergillosis (0.81 cases per 100,000 population [0.81/100,000]) was 11-fold higher than that of mucormycosis (0.07/100,000). A significant increase in incidence was observed for aspergillosis (from 0.48/100,000 in 2006 to 1.19/100,000 in 2017, p <.0001) but not for mucormycosis (from 0.04/100,000 in 2006 to 0.11/100,000 in 2017, p =.07). The major underlying disease identified was diabetes mellitus (60.8%) for mucormycosis and malignant neoplasms (45.9%) for aspergillosis. The all-cause 90-day mortality rate was similar between mucormycosis and aspergillosis patients (39% vs. 37%, p =.60). For mucormycosis patients, multivariate analysis revealed that posaconazole use was associated with lower in-hospital mortality (aOR 0.38; 95% CI 0.15–0.97; p =.04). Conclusions: Mucormycosis is an uncommon fungal disease in Taiwan, occurring mostly in diabetic patients. However, the incidence might be underestimated due to limited diagnostics. Continuous surveillance might aid in delineating the evolving features of mucormycosis.
AB - Background: Epidemiological knowledge of mucormycosis obtained from national population-based databases is scarce. Objectives: This study aimed to depict the disease burden and demographics of mucormycosis in Taiwan by using the Taiwan National Health Insurance Research Database (NHIRD) and those of aspergillosis as a comparator. Methods: Data from patients with either mucormycosis or aspergillosis from 2006 to 2017 identified with the International Classification of Diseases (ICD) codes were extracted from the NHIRD. The incidence, demographics and clinical data of both diseases were analysed. Results: A total of 204 patients with mucormycosis and 2270 patients with aspergillosis who were hospitalised and treated with mould-active antifungals between 2006 and 2017 were identified. The average annual incidence of aspergillosis (0.81 cases per 100,000 population [0.81/100,000]) was 11-fold higher than that of mucormycosis (0.07/100,000). A significant increase in incidence was observed for aspergillosis (from 0.48/100,000 in 2006 to 1.19/100,000 in 2017, p <.0001) but not for mucormycosis (from 0.04/100,000 in 2006 to 0.11/100,000 in 2017, p =.07). The major underlying disease identified was diabetes mellitus (60.8%) for mucormycosis and malignant neoplasms (45.9%) for aspergillosis. The all-cause 90-day mortality rate was similar between mucormycosis and aspergillosis patients (39% vs. 37%, p =.60). For mucormycosis patients, multivariate analysis revealed that posaconazole use was associated with lower in-hospital mortality (aOR 0.38; 95% CI 0.15–0.97; p =.04). Conclusions: Mucormycosis is an uncommon fungal disease in Taiwan, occurring mostly in diabetic patients. However, the incidence might be underestimated due to limited diagnostics. Continuous surveillance might aid in delineating the evolving features of mucormycosis.
UR - http://www.scopus.com/inward/record.url?scp=85133048728&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85133048728&partnerID=8YFLogxK
U2 - 10.1111/myc.13484
DO - 10.1111/myc.13484
M3 - Article
C2 - 35713608
AN - SCOPUS:85133048728
SN - 0933-7407
VL - 65
SP - 1001
EP - 1009
JO - Mycoses
JF - Mycoses
IS - 11
ER -