Link to Pubmed [PMID] – 40742288
Link to DOI – 10.1093/cid/ciaf423
Clin Infect Dis 2025 Jul; ():
Invasive fungal diseases, among which includes invasive wound mucormycosis (IWM), are associated with poor outcomes in severely burned patients (SBP). In recent years, quantitative real-time PCR in serum to detect circulating Mucorales DNA (cmDNA) has shown promise for early diagnosis, reducing treatment duration and improving survival. Similarly, recent studies suggest that cmDNA detection enabled earlier diagnosis of IWM in SBP. This retrospective study aimed to assess the impact of cmDNA-based diagnosis compared to conventional fungal culture on all-cause mortality at 30 and 100-day in SBP.We retrospectively analyzed medical records of SBP with proven or probable IWM over two periods, before and after the systematic implementation of cmDNA detection across two centers.A total of 37 IWM patients were included. No significant differences were observed in clinical characteristics, treatment regimens, or disease severity between both groups. Our findings indicate that systematic cmDNA detection allowed earlier diagnosis of IWM with a median of -8 days [-16; -4] than mycological culture. The 100-day mortality was reduced from 63.6 % to 30.8 % (p = 0.071), and significantly reduced when considering only patients with total body surface area (TBSA) ≥ 30 % (p = 0.047), in the cmDNA group. This earlier detection was associated with early initiation of liposomal amphotericin B-based therapy combined with surgery and may have contributed to the improved outcome.cmDNA screening in targeted high-risk SBP allows for earlier initiation of specific treatment and appears to improve the prognosis of IWM.