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Mucormycosis in patients with diabetes mellitus in Russia: registry data analysis

https://doi.org/10.22625/2072-6732-2026-18-1-5-17

Abstract

We observed 100 patients with mucormycosis from 2002 to 2024. We used the EORTC/MSGERC 2019, 2020 criteria for diagnosing mucormycosis. Mucormycosis developed against the background of type 2 diabetes mellitus in 10% of patients, type 1 in 7%, in 83% – after coronavirus infection COVID-19 and glucocorticosteroid therapy. The average glycemia level on the day of diagnosis of mucormycosis was 17 mmol / l. Other risk factors were ketoacidosis – 48%, use of glucocorticosteroids – 85%, lymphocytopenia 44%. The main clinical variant was rhinoorbitocerebral mucormycosis – 93%. Less frequently were mucormycosis of brain (37%), skin (25%), lungs (8%), kidneys (1%). Antifungal therapy was used in 96% of patients: рosaconazole (69%), amphotericin B deoxycholate (59%), lipid forms of amphotericin B (25%), isavuconazole (17%). Surgical treatment used 97%. 12 weeks overall survival was 80%.

About the Authors

S. N. Khostelidi
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Saint-Petersburg


Competing Interests:

none



S. A. Vartanyan
Regional Clinical Hospital of Emergency Medical Care
Russian Federation

Krasnodar


Competing Interests:

none



A. O. Charushin
Perm State Medical University named after academician E.A. Wagner
Russian Federation

Perm


Competing Interests:

none



A. V. Vagin
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Saint-Petersburg


Competing Interests:

none



O. P. Kozlova
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Saint-Petersburg


Competing Interests:

none



T. S. Bogomolova
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Saint-Petersburg


Competing Interests:

none



S. M. Ignatyeva
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Saint-Petersburg


Competing Interests:

none



Yu. L. Avdeenko
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Saint-Petersburg


Competing Interests:

none



Yu. V. Borzova
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Saint-Petersburg


Competing Interests:

none



N. V. Vasilyeva
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Saint-Petersburg


Competing Interests:

none



References

1. Skiada A, Pavleas I, Drogari-Apiranthitou M. Epidemiological Trends of Mucormycosis in Europe, Comparison with Other Continents. Mycopathologia. 2024;189(6):100. DOI:10.1007/s11046-024-00907-5

2. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41(5):634-653. DOI:10.1086/432579.

3. Jeong W, Keighley C, Wolfe R, et al. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clin Microbiol Infect. 2019;25(1):26-34. DOI:10.1016/j.cmi.2018.07.011

4. Skiada A, Pagano L, Groll A, et al. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbiol Infect. 2011;17(12):1859-1867. DOI:10.1111/j.1469-0691.2010.03456.x

5. Arora U, Priyadarshi M, Katiyar V, et al. Risk factors for Coronavirus disease-associated mucormycosis. J Infect. 2022;84(3):383-390. DOI:10.1016/j.jinf.2021.12.039.

6. All-India Mucormycosis Consortium. Survival and quality-of-life in Mucormycosis: a multicentric ambispective cohort study. Clin Microbiol Infect. 2025 Jun 12:S1198743X(25)00286-1. DOI: 10.1016/j.cmi.2025.06.001.

7. Pandey V, Kubre J, Vatsalya T, Ahirwar K, Mehrotra S. A Tragic Tale of Mucormycosis and COVID-19: An Observational Study to Identify Predisposing Risk Factors and Outcomes in a Tertiary Care Centre in Central India. Cureus. 2025;17(5):e83479. DOI:10.7759/cureus.83479

8. Dolatabadi S, Ahmadi B, Rezaei-Matehkolaei A, et al. Mucormycosis in Iran: A six-year retrospective experience. J Mycol Med. 2018;28(2):269-273. DOI:10.1016/j.mycmed.2018.02.014

9. Zeka AN, Taşbakan M, Pullukçu H, et al. Evaluation of zygomycosis cases by pooled analysis method reported from Turkey. Mikrobiyol Bul. 2013;47(4):708-716. DOI:10.5578/mb.5836.

10. Sahin M, Yilmaz M, Mert A, et al. Factors influencing mortality in COVID-19-associated mucormycosis: The international ID-IRI study. Med Mycol. 2024;62(7):myae064. DOI:10.1093/mmy/myae064.

11. Corzo-León DE, Chora-Hernández LD, Rodríguez-Zulueta AP, Walsh TJ. Diabetes mellitus as the major risk factor for mucormycosis in Mexico: Epidemiology, diagnosis, and outcomes of reported cases. Med Mycol. 2018;56(1):29-43. DOI:10.1093/mmy/myx017

12. Nucci M, Engelhardt M, Hamed K. Mucormycosis in South America: A review of 143 reported cases. Mycoses. 2019 Sep;62(9):730-738. DOI: 10.1111/myc.12958.

13. Stemler J, Hamed K, Salmanton-García J, et al. Mucormycosis in the Middle East and North Africa: Analysis of the FungiScope® registry and cases from the literature. Mycoses. 2020;63(10):1060-1068. DOI:10.1111/myc.13123.

14. Sen M, Honavar SG, Bansal R, et al. Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 patients in India – Collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), Report 1. Indian J Ophthalmol. 2021;69(7):16701692. DOI:10.4103/ijo.IJO_1565_21

15. Muthu V, Rudramurthy SM, Chakrabarti A, Agarwal R. Epidemiology and Pathophysiology of COVID-19-Associated Mucormycosis: India Versus the Rest of the World. Mycopathologia. 2021;186(6):739-754. DOI:10.1007/s11046-021-00584-8

16. Hoenigl M, Seidel D, Carvalho A, et al. The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries. Lancet Microbe. 2022;3(7):e543-e552. DOI:10.1016/S2666-5247(21)00237-8

17. Seidel D, Simon M, Sprute R, et al. Results from a national survey on COVID-19-associated mucormycosis in Germany: 13 patients from six tertiary hospitals. Mycoses. 2022;65(1):103-109 DOI:10.1111/myc.13379

18. Pakdel F, Ahmadikia K, Salehi M, et al. Mucormycosis in patients with COVID-19: A cross-sectional descriptive multicentre study from Iran. Mycoses. 2021;64(10):1238-1252. DOI:10.1111/myc.13334

19. Gangneux JP, Dannaoui E, Fekkar A, et al. Fungal infections in mechanically ventilated patients with COVID-19 during the first wave: the French multicentre MYCOVID study. Lancet Respir Med. 2022;10(2):180-190. DOI:10.1016/S2213-2600(21)00442-2

20. Riad A, Shabaan AA, Issa J, et al. COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors. J Fungi (Basel). 2021;7(10):837. DOI:10.3390/jof7100837

21. Klimko N.N., Kozlova Ya.I., Khostelidi S.N. et al. The prevalence of serious and chronic fungal diseases in Russian Federation on LIFE program model. Problems in Medical Mycology 2014;16(1):3-8. (In Russ.).

22. Khostelidi S.N. Severe fungal infections caused by rare pathogens: dissertation for the degree of Doctor of Medical Sciences. Saint Petersburg, 2023: 314 p. (In Russ.).

23. Nurtdinova G.M., Suleymanov A.M., Bayazitov Ian I. et al. Clinical case of mucormycosis in patient COVID-19. Case report. Therapevticheskii Arkhive (Ter. Arkh.). 2022;94(11):1320– 1325 (in Russ.).

24. Kulagina L. Yu., Kurbanov A. R. Cases of mucormycosis in the Republican Clinical Hospital of Kazan. GLAVVRACH. 2022;9. (in Russ.)].

25. Charushin O.A., Khostelidi S.N., Borovinsky R.I., et al. A case of successful treatment of rhinoorbital mucormycosis in a patient with COVID-19 in the Perm Territory. Problems of Medical Mycology. 2022;24(3):13-19. (in Russ.)].

26. Makarov A. A., Orazvaliev A. I., Ushakov R. V., Zhabko E. V. Rhino-orbitocerebral mucormycosis associated with COVID-19 and diabetes. Russian Rhinology. 2022;30(3):210-216. (in Russ.)].

27. Rebyatnikova M. A., Evtukh G. N., Rudzevich A. V., et al. Cases of mucormycosis after new coronavirus infection (COVID-19) in a multidisciplinary hospital. Clinical microbiology and antimicrobial chemotherapy. 2022;24(S1):30. (in Russ.).

28. Boyko N.V., Kolesnikov V.N., Khanamirov A.A. et al. COVID-19-associated sinoorbital mucormycosis. Bulletin of otorhinolaryngology. 2023;88(2):31-37. (in Russ.).

29. Khostelidi S. N., Zaitsev V. A., Pelikh E. V., et al. Mucormycosis in the context of COVID-19: description of a clinical case and literature review. Clinical microbiology and antimicrobial chemotherapy. 2021;23(3):255-262.].

30. Smirnov AV, Ermilov VV, Sasin AN, et al. Fatal case of rhinocerebral mucormycosis on the background of type II diabetes mellitus. Russian Journal of Archive of Pathology. 2024;86(3):52-58. (In Russ.).

31. Dunts P.V., Dogadova L.P., Romanchuk A.L., Ignatiev S.K., Khostelidi S.N., Avdeenko Yu.L., Bogomolova T.S. The first case of invasive mucormycosis in the intensive care unit in Primorsky Krai. Problems of Medical Mycology. 2025;27(2):36-45. (In Russ.).

32. Khostelidi S.N., Shadrivova O.V., Klimko N.N. Certificate of state registration of the database No. 2023621687 Russian Federation. “Mucormycosis in adult patients” (“Database based on the results of consultations of staff of the Department of Clinical Mycology, Allergology and Immunology of I.I. Mechnikov NWSMU on the basis of the Kashkin Research Institute of Medical Mycology”): №2023621379: application 05/15/2023: publ. 05/25/2023/; applicant NWSMU named after I.I. Mechnikov MH of RF. – EDN HKWUCY. (In Russ).

33. Cornely O.A., Alastruey-Izquierdo A., Arenz D., 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. Lancet Infect. Dis. 2019; 19 (12): e405-e421. DOI: 10.1016/S1473-3099(19)30312-3.

34. Donnelly J.P., Chen S.C., Kauffman C.A., 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. Clin. Infect. Dis. 2020; 71 (6): 1367-1376. DOI: 10.1093/cid/ciz1008.

35. Zhou C, Byard RW. An analysis of the morbidity and mortality of diabetes mellitus in a forensic context. J Forensic Sci. 2018;63:1149–1154. DOI: 10.1111/1556-4029.13674.

36. Yang W, Dall TM, Beronjia K, et al. Economic costs of diabetes in the U.S. in 2017. Diabetes Care. 2018;41:917–928. DOI: 10.2337/dci18-0007.

37. Prakash H, Chakrabarti A. Global epidemiology of mucormycosis. J Fungi (Basel). 2019;5. DOI: 10.3390/jof5010026.

38. Walther, G., Wagner, L. & Kurzai, O. Outbreaks of Mucorales and the Species Involved. Mycopathologia. 2020; 185, 765–781. DOI: 10.1007/s11046-019-00403-1.

39. Frąc M, Hannula SE, Bełka M, Jędryczka M. Fungal Biodiversity and Their Role in Soil Health. Front Microbiol. 2018;9:707. DOI: 10.3389/fmicb.2018.00707

40. Morin-Sardin S., Nodet P., Coton E., Jany J. L. Mucor: a janus-faced fungal genus with human health impact and industrial applications. Fungal Biol. Rev. 2017.31 (1), 12–32. DOI: 10.1016/j.fbr.2016.11.002

41. WHO fungal priority pathogens list to guide research, development and public health action. World Health Organization (WHO). Available from: https://www.who.int/publications/i/item/9789240060241

42. Skiada A, Drogari-Apiranthitou M, Roilides E, et al. A Global Analysis of Cases of Mucormycosis Recorded in the European Confederation of Medical Mycology / International Society for Human and Animal Mycology (ECMM / ISHAM) Zygomyco.net Registry from 2009 to 2022. Mycopathologia. 2025;190(4):53. DOI: 10.1007/s11046-025-00954-6

43. Gouzien L, Che D, Cassaing S, et al. Epidemiology and prognostic factors of mucormycosis in France (2012-2022): a cross-sectional study nested in a prospective surveillance programme. Lancet Reg Health Eur. 2024;45:101010. DOI: 10.1016/j.lanepe.2024.101010.

44. Alqarihi A, Kontoyiannis DP, Ibrahim AS. Mucormycosis in 2023: an update on pathogenesis and management. Front Cell Infect Microbiol. 2023;13:1254919. DOI: 10.3389/fcimb.2023.1254919.

45. Morales-Franco B, Nava-Villalba M, Medina-Guerrero EO, Sánchez-Nuño YA, Davila-Villa P, Anaya-Ambriz EJ, Charles-Niño CL. Host-Pathogen Molecular Factors Contribute to the Pathogenesis of Rhizopus spp. in Diabetes Mellitus. Curr Trop Med Rep. 2021;8(1):6-17. DOI: 10.1007/s40475-02000222-1.

46. Navarro-Mendoza MI, Pérez-Arques C, Murcia L, et al. Components of a new gene family of ferroxidases involved in virulence are functionally specialized in fungal dimorphism. Sci Rep. 2018;8:1–13. DOI: 10.1038/s41598-018-26051-x.

47. Andrianaki AM, Kyrmizi I, Thanopoulou K, et al. Iron restriction inside macrophages regulates pulmonary host defense against Rhizopus species. Nat Commun. 2018;9(1):3333. DOI: 10.1038/s41467-018-05820-2.

48. Salazar-Tamayo G, López-Jácome LE, Resendiz-Sanchez J, Franco-Cendejas R, Rodriguez-Zulueta P, Corzo-León DE. Higher in vitro proliferation rate of Rhizopus oryzae in blood of diabetic individuals in chronic glycaemic control compared with non-diabetic individuals. Mycopathologia. 2017;182:1005–1014. DOI:10.1007/s11046-017-0174-0.

49. Frolova E. V., Filippova L. V., Uchevatkina A. E., Aak O. V., Solovieva G. I., Taraskina A. E., and Vasilyeva N. V.. [Features of the interaction of immune system cells with fungi of the order Мucorales. Problems of Medical Mycology. 2020; 22(2):3-11.

50. Roberds A, Bobrov AG, Rautemaa-Richardson R, Walsh TJ. Invasive Fungal Diseases of Combat Wounds: Burden, Epidemiology, and Mycology. Mycopathologia. 2024;189(6):102. DOI:10.1007/s11046-024-00908-4.

51. Walsh TJ, Hospenthal DR, Petraitis V, and Kontoyiannis DP: Necrotizing mucormycosis of wounds following combat injuries, natural disasters, burns, and other trauma. J Fungi. 2019;5: 57. DOI: 10.3390/jof5030057.

52. Khostelidi, S. N. Experience with isavuconazole for the treatment of mucormycosis: description of a clinical case and analysis of registry data. Clinical microbiology and antimicrobial chemotherapy. 2024;26(4):529-536.

53. Özbek L, Topçu U, Manay M, Esen BH, Bektas SN, Aydın S, Özdemir B, Khostelidi SN, Klimko N, Cornely O, Zakhour J, Kanj SS, Seidel D, Hoenigl M, Ergönül Ö. COVID-19-associated mucormycosis: a systematic review and meta-analysis of 958 cases. Clin Microbiol Infect. 2023;29(6):722-731. DOI: 10.1016/j.cmi.2023.03.008.


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For citations:


Khostelidi S.N., Vartanyan S.A., Charushin A.O., Vagin A.V., Kozlova O.P., Bogomolova T.S., Ignatyeva S.M., Avdeenko Yu.L., Borzova Yu.V., Vasilyeva N.V. Mucormycosis in patients with diabetes mellitus in Russia: registry data analysis. Journal Infectology. 2026;18(1):5-17. (In Russ.) https://doi.org/10.22625/2072-6732-2026-18-1-5-17

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