OPPORTUNISTIC INFECTION OF MUCORMYCOSIS DURING COVID-19 AND ITS CLINICO-MYCOLOGICAL PROFILE AND ANTIFUNGAL SUSCEPTIBILITY PATTERNS.

Abstract

A serious opportunistic fungal illness, zygomycosis has become more common during the COVID-19 pandemic, especially in immunocompromised people like those with diabetes mellitus. The current study's objective is to assess the clinico-mycological profile of mucormycosis and identify patterns of antifungal susceptibility, including the minimum inhibitory concentrations (MICs) of widely used antifungal medications. There were fifty clinical isolates that tested positive for mucormycosis. Samples were taken from lung and brain tissues, wounds, nasal swabs, bronchoalveolar lavage, bronchial wash, and paranasal sinuses. Gene sequencing, microscopy, and culture were used for identification. The CLSI M38-A2 broth microdilution method was used to test for antifungal susceptibility to itraconazole, posaconazole, voriconazole, and amphotericin B. The most common isolate (83%) was Rhizopus spp., followed by Apophysomyces variabilis (7%), Lichtheimia corymbifera (7%), and Cunninghamella bertholletiae (2%). Among the antifungal drugs under investigation, amphotericin B demonstrated the greatest efficacy, followed by posaconazole. Voriconazole and itraconazole were mainly unsuccessful. Mucormycosis remains a potentially fatal illness, particularly in individuals with diabetes and a history of COVID-19. The most frequent etiological agent is still Rhizopus spp. The antifungal drugs posaconazole and amphotericin B are thought to be the most likely to work, highlighting the significance of regular susceptibility testing for the best possible treatment results.