Isolation and identification of mucormycosis-causing fungi from patient samples.

Mucormycosis (also called zygomycosis or black fungus) is a serious but fortunately relatively rare fungal infection caused by a group of molds in the zygomycete family. Mucormycosis diagnostics are usually based on the cultivation and identification of the pathogen.

Initiators of mucormycosis include the fungal genera Mucor, Rhizomucor, Rhizopus, Syncephalastrum, Apophysomyces, Lichtheimia, and Cunninghamella. These fungi are found virtually everywhere in the environment; they are especially prevalent in soil and decaying organic material such as leaves, compost, or dead wood.
The fungus generally enters the body either by inhaling the fungal spores, or also through wounds on the skin (cuts, abrasions or often burns).

For healthy people with a functioning immune system, the filamentous fungi do not actually pose any danger. The situation is quite different for immunocompromised or immunodeficient people. Individuals with acute leukemia (mostly children) and patients who suffer from diabetic ketoacidosis, take high doses of corticoids, or have received an organ or stem cell transplant are particularly affected by mucormycosis. Mucormycosis may also occur as a result of severe COVID-19 disease. This has been seen recently in India, where the number of cases has increased extremely with the recent Corona wave and mycomycosis now is causing additional incredible suffering.

Depending on how the fungus entered the body and which organ/tissue is affected by the infection, different forms of mucormycosis disease occur. All are life-threatening and have a more or less poor prognosis.

The most common form, rhinoorbitocerebral mucormycosis (sinuses and CNS), kills about one in two patients and in pulmonary mucormycosis (lungs), 2/3 of patients die. Disseminated mucormycosis (spreading from the lungs to other organs and the CNS) mainly affects children with acute leukemia and is virtually always fatal. The situation is much better with mucormycosis of the skin; here the survival rate is about 85%.

Precondition for a cure a rapid mucormycosis diagnosis and immediate start of treatment. If left untreated, mucormycosis is always a lethal condition.

A quick and clear diagnosis of the disease is essential in order to offer patients the prospect of a cure. The diagnosis is primarily made by biopsy (sterile removal of a tissue sample), identification of the pathogen through the creation of a fungal culture, microscopy and/or histopathological evidence.

HiMedia offers a comprehensive range of products for mucormycosis diagnostics: culture media and antimycotics for the isolation of fungi from patient samples and subsequent antimycotic profiling.

Powder media for the isolation of mucormycosis pathogens

Cultivation / Propagation

  • GM063 Sabouraud Dextrose Agar, Granulated
  • MV063 Sabouraud Dextrose HiVeg™ Agar
  • MCD063 Sabouraud Dextrose HiCynth™ Agar
  • M096 Potato Dextrose Agar
  • GM096 Potato Dextrose Agar, Granulated
  • MCD096 Potato Dextrose HiCynth™ Agar
  • M842 Rose Bengal Agar Base
  • GM842 Rose Bengal Agar Base, Granulated
  • M1467 HiCrome™ OGYE Agar Base

Selective Isolation

  • M1067 Sabouraud Chloramphenicol Agar
  • MV1067 Sabouraud Chloramphenicol HiVeg™ Agar
  • M1008 Chloramphenicol Yeast Glucose Agar
  • M640 Rose Bengal Chloramphenicol Agar
  • MV640 Rose Bengal Chloramphenicol HiVeg™ Agar
  • M1941 Potato Dextrose Agar w/ Chloramphenicol
HiCrome™ OGYE Agar Base
Candida sp. (white fungus): Green colonies appear on the differential medium HiCrome™ OGYE Agar Base [M1467]. The used sample was from a COVID-19 patient.

Antifungal Susceptibility Testing Resources for Mucormycosis Fungal Pathogens

Amphotericin HiComb™ MIC Modified [MDM071, Bereich 0,002 - 32 μg/ml].
Antifungal susceptibility testing of white fungal isolates (Candida sp.) from COVID-19 patient samples using Amphotericin HiComb™ MIC Modified [MDM071, range 0.002 - 32 μg/ml].
Amphotericin Ezy MIC™ Strip [EM071]
Antifungal susceptibility testing of mucormycosis (black fungus) isolates from COVID-19 patient samples with Amphotericin Ezy MIC™ Strip [EM071].
Ketoconazol Single Disc [SD275].
Antifungal susceptibility testing of white fungal isolates (Candida sp.) from COVID-19 patient samples with ketoconazole single disc [SD275].

Powder Media for MIC Determination

  • M1825 Mueller Hinton Agar 2% Glucose w/ Methylene blue
  • M2067 HiCrome™ Mueller Hinton Agar (For antifungal testing)

Antifungal Ezy MIC™ Strips

  • EM071 Amphotericin B Ezy Mic Strip (0.002-32 µg/ml)
  • EM122 Anidulafungin Ezy Mic Strip (0.002-32 µg/ml)
  • EM119 Caspofungin Ezy Mic Strip (0.002-32 µg/ml)
  • EM144 Clotrimazole Ezy Mic Strip (0.002-32 µg/ml)
  • EM072 Fluconazole Ezy Mic Strip (0.016-256 µg/ml)
  • EM118 Flucytosine Ezy Mic Strip (0.002-32 µg/ml)
  • EM143 Griseofulvin Ezy Mic Strip (0.002-32 µg/ml)

Antifungal HiComb™ MIC Test

  • MD071 Amphotericin B HiComb MIC Test (Part A: 32-0.25 µg; Part B: 0.256-0.002 µg)
  • MD072 Fluconazole HiComb MIC Test (Part A: 256-2 µg; Part B: 2.048-0.016 µg)
  • MD074 Ketoconazole HiComb MIC Test (Part A: 32-0.25 µg; Part B: 0.256-0.002 µg)
  • MD073 Itraconazole HiComb MIC Test (Part A: 32-0.25 µg; Part B: 0.256-0.002 µg)

Antifungal Sensitivity Discs

  • SD111 Amphotericin B, 100 units
  • SD233 Amphotericin B, 20 µg
  • SD270 Amphotericin B, 50 µg
  • SD115 Clotrimazole, 10 µg
  • SD114 Fluconazole, 10 µg
  • SD221 Itraconazole, 10 µg
  • SD276 Itraconazole, 30 µg
  • SD224 Ketonazole, 10 µg
  • SD275 Ketonazole, 30 µg
  • SD274 Ketonazole, 50 µg
  • SD273 Miconazole, 30 µg
  • SD272 Miconazole, 50 µg
  • SD025 Nystatin, 100 units
  • SD271 Nystatin, 50 µg

Presumptive Staining for Fungal Isolates

  • S015 Lactophenol
  • S016 Lactophenol Cotton Blue
  • S017 Lactophenol Picric Acid
  • S031 Mayer′s Mucicarmine Stain