Microbiological Profile and Antifungal Susceptibility Patterns of Mucormycosis Isolates in COVID-19–Associated Cases

Background: The COVID-19 pandemic witnessed an unprecedented surge in mucormycosis cases, particularly among patients with uncontrolled diabetes mellitus and corticosteroid exposure. Understanding the microbiological spectrum and antifungal susceptibility patterns of causative agents is essential for optimizing therapeutic strategies. Methods: This prospective observational study was conducted. Clinical specimens from 156 confirmed CAM patients were processed for fungal culture, molecular identification, and antifungal susceptibility testing using the broth microdilution method following CLSI M38-A2 guidelines. Results: Among 156 patients, culture positivity was achieved in 124 cases (79.5%). Rhizopus arrhizus was the predominant species (58.1%), followed by Rhizopus microsporus (16.9%), Mucor circinelloides (10.5%), and Lichtheimia corymbifera (8.1%). Rhino-orbital-cerebral mucormycosis was the most common presentation (82.7%). Diabetes mellitus was present in 142 patients (91.0%), with mean HbA1c of 10.8 ± 2.4%. Among antifungals tested, amphotericin B demonstrated lowest geometric mean MIC (0.38 µg/mL), followed by posaconazole (0.52 µg/mL) and isavuconazole (0.86 µg/mL). Elevated MICs to amphotericin B (≥2 µg/mL) were observed in 8.9% of isolates. All isolates showed high MICs to fluconazole (>64 µg/mL) and voriconazole (>8 µg/mL). Mortality rate was 34.6%, with significantly higher mortality in disseminated disease (71.4%) compared to localized infection (28.2%, p<0.001). Conclusion: Rhizopus arrhizus remains the predominant etiological agent in CAM. While amphotericin B and posaconazole maintain good in vitro activity, emergence of isolates with elevated MICs warrants continued surveillance. Species-level identification and susceptibility testing are crucial for optimizing antifungal therapy.

• Publication year

  2026

• Venue

  International Journal of Current Pharmaceutical Review and Research

• Publication date

  2026-02-22

• Fields of study

  Not labeled

• Identifiers
  DOI 10.25258/ijcpr.18.2.17
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

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