1616. Trends in Mucormycosis-Related Hospitalizations, United States, 2000─2013
Session: Poster Abstract Session: Mycology - There's a Fungus Among Us: Epidemiology
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Mucor trends IDSA poster (2).pdf (318.5 kB)
  • Background: The incidence of mucormycosis, a severe, often fatal, invasive mold infection (IMI) which primarily occurs in immunocompromised persons, may be increasing, while other IMIs such as invasive aspergillosis (IA) may be decreasing because of use of antifungal prophylaxis targeting IA. We estimated trends in mucormycosis (M)-related hospitalizations (RH) in the United States during 2000─2013, and compared trends in M-RH with IA-RH occurring in conjunction with certain underlying conditions including hematologic malignancy (HM), hematopoietic stem cell transplant (HSCT), and solid organ transplant (SOT).

    Methods: Using ICD-9 codes available in the National (Nationwide) Inpatient Sample, a nationally representative hospital discharge database, we estimated numbers of M-RH, IA-RH, HM-RH, HSCT-RH, and SOT-RH. US census data was used to calculate yearly overall M-RH rates and rates by sex and region. HM-RH, HSCT-RH, and SOT-RH were used to calculate M-RH and IA-RH rates occurring in conjunction with these conditions. Weighted least-squares technique was used on log transformed rates to test for linear trends and estimate average annual percent change (APC). 

    Results: The annual estimated number of M-RH rose from 485 in 2000 to 1080 in 2013; corresponding M-RH rates rose from 1.7 to 3.4 per one million persons (APC: +5.15%; p<0.001). Males had higher M-RH rates than females; the Northeast region had the lowest M-RH rates compared with the West, South, and Midwest. Among HM-RH, the M-RH rates increased (APC: +7.0% (p<0.0001), but IA-RH rates did not change significantly. There was no significant change in M-RH rates (APC: 2.0%, p=0.50) occurring among HSCT-RH, but a significant decline occurred in IA-RH rates (APC: ─4.6%; p=0.004). Among SOT-RH, M-RH rates (APC: +6.3%; p=0.04) and IA-RH rates (APC: +4.1%; p=0.0009) both increased over the study period.

    Conclusion: Overall M-RH rates doubled during 2000─2013. M-RH rates occurring in conjunction with certain underlying conditions increased while IA-RH rates either decreased, remained stable, or increased to a lesser extent than M-RH. Antifungal prophylaxis regimens may play a role in the observed trends. Mucormycosis is an increasingly important IMI, and control measures are needed.

    Snigdha Vallabhaneni, MD, MPH1, Kaitlin Benedict, MPH1, Gordana Derado, PhD2 and Rajal K. Mody, MD, MPH1, (1)Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, (2)Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA

    Disclosures:

    S. Vallabhaneni, None

    K. Benedict, None

    G. Derado, None

    R. K. Mody, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.