https://www.cidrap.umn.edu/fungal-infection/invasive-mold-disease-linked-high-rates-icu-care-death
Invasive mold disease linked to high rates of ICU care, death
Laine Bergeson
Today at 9:04 a.m.
Fungal Infection
The findings, published in Morbidity and Mortality Weekly Report, are based on active, laboratory-based surveillance at two Atlanta-area academic hospitals and outpatient clinics from 2020 through 2024.
Critical illness a notable IMD risk factor
IMDs occur when certain types of mold enter the body either through inhalation of mold spores from the environment, exposure to contaminated medical devices and healthcare linens or products, or as part of healthcare-associated outbreaks.
The mold spores then travel deep inside the body, damaging tissues and organs and affecting a range of body systems, including the lungs, sinuses, skin, and central nervous system (CNS).
For the report, researchers led by a team at the CDC identified 968 patients with potential IMD. Of those, 449 (46%) had an infection, including 89 with confirmed cases, 142 with probable cases, and 218 with surveillance cases, or those presumptively treated as IMD.
35% of patients had none of the classic risk factors used to identify people who are predisposed to infections.
Lung infections were by far the most common manifestation, accounting for 68% of cases. Skin or deep-tissue infections accounted for 11%, sinus or nasal infections for 10%, and CNS infections for 9%. A very small percentage of infections occurred in non-skin soft tissues (2%) and blood, bone, and eye, at 1% each.
Although IMD typically affects people with weakened or compromised immune systems, 35% of patients had none of the classic risk factors used to identify people predisposed to infections, “underscoring the need for clinicians and surveillance efforts to consider the possibility of IMDs among patients without classic host risk factors for infection,” write the researchers
Fifty-eight patients (13%) had a current or recent COVID-19 infection. Critical illness, particularly severe COVID and influenza, “is increasingly recognized as an IMD risk factor,” the researchers note.
Worse outcomes in COVID patients
In the study, IMD infections were associated with significant illness and death. In all, 43% of patients were admitted to an intensive care unit (ICU) and 50% required intubation and mechanical ventilation. For patients for whom mortality data were available, 45% died within 90 days.
Patients with a current or recent COVID infection had particularly poor outcomes, with 66% admitted to the ICU, compared with 39% in those without a COVID infection. The 90-day all-cause mortality rate among those with a current or recent COVID infection was also 66%, compared with 41% without an infection.
While IMDs are rare, the findings highlight their potential severity. And with more than one-third of cases occurring in patients without traditional risk factors, they underscore the need to consider IMD in even low-risk patients, the researchers write. To help improve patient outcomes, the researchers call for earlier and more accurate case detection, as well as improved antifungal treatments.
Invasive mold disease linked to high rates of ICU care, death
Laine Bergeson
Today at 9:04 a.m.
Fungal Infection
New surveillance data from the Centers for Disease Control and Prevention (CDC) highlight the severity of invasive mold disease (IMD), finding that, during five years, 45% of patients with IMD at four hospitals died within 90 days, and half required mechanical ventilation.The findings, published in Morbidity and Mortality Weekly Report, are based on active, laboratory-based surveillance at two Atlanta-area academic hospitals and outpatient clinics from 2020 through 2024.
Critical illness a notable IMD risk factor
IMDs occur when certain types of mold enter the body either through inhalation of mold spores from the environment, exposure to contaminated medical devices and healthcare linens or products, or as part of healthcare-associated outbreaks.
The mold spores then travel deep inside the body, damaging tissues and organs and affecting a range of body systems, including the lungs, sinuses, skin, and central nervous system (CNS).
For the report, researchers led by a team at the CDC identified 968 patients with potential IMD. Of those, 449 (46%) had an infection, including 89 with confirmed cases, 142 with probable cases, and 218 with surveillance cases, or those presumptively treated as IMD.
35% of patients had none of the classic risk factors used to identify people who are predisposed to infections.
Lung infections were by far the most common manifestation, accounting for 68% of cases. Skin or deep-tissue infections accounted for 11%, sinus or nasal infections for 10%, and CNS infections for 9%. A very small percentage of infections occurred in non-skin soft tissues (2%) and blood, bone, and eye, at 1% each.
Although IMD typically affects people with weakened or compromised immune systems, 35% of patients had none of the classic risk factors used to identify people predisposed to infections, “underscoring the need for clinicians and surveillance efforts to consider the possibility of IMDs among patients without classic host risk factors for infection,” write the researchers
Fifty-eight patients (13%) had a current or recent COVID-19 infection. Critical illness, particularly severe COVID and influenza, “is increasingly recognized as an IMD risk factor,” the researchers note.
Worse outcomes in COVID patients
In the study, IMD infections were associated with significant illness and death. In all, 43% of patients were admitted to an intensive care unit (ICU) and 50% required intubation and mechanical ventilation. For patients for whom mortality data were available, 45% died within 90 days.
Patients with a current or recent COVID infection had particularly poor outcomes, with 66% admitted to the ICU, compared with 39% in those without a COVID infection. The 90-day all-cause mortality rate among those with a current or recent COVID infection was also 66%, compared with 41% without an infection.
While IMDs are rare, the findings highlight their potential severity. And with more than one-third of cases occurring in patients without traditional risk factors, they underscore the need to consider IMD in even low-risk patients, the researchers write. To help improve patient outcomes, the researchers call for earlier and more accurate case detection, as well as improved antifungal treatments.