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Molecular phylogenetic analysis confirmed the phylum Zygomycota to be polyphyietic, and the taxa conventionally classified in Zygomycota are now distributed among the new phylum Glomeromycota and 4 subphyla incertae sedis (uncertain placement). Because the nomenclature of the disease zygomycosis was based on the phylum Zygomycota (Zygomycetes) in which the etiologic agents had been classified, the new classification profoundly affects the name of the disease. Zygomycosis was originally described as a convenient and inclusive name for 2 clinicopathologically different diseases, mucormycosis caused by members of Mucorales and entomophthoramycosis caused by species in the order Entomophthorales of Zygomycota. Without revision of original definition, the name \"zygomycosis,\" however, has more often been used as a synonym only for mucormycosis. This article reviews the progress and changes in taxonomy and nomenclature of Zygomycota and the disease zygomycosis. The article also reiterates the reasons why the classic names \"mucormycosis\" and \"entomophthoramycosis\" are more appropriate than \"zygomycosis.\"

Early diagnosis of invasive mucormycosis is important for timely therapeutic intervention, improved survival, and reduced morbidity. Given the importance of an accurate and rapid diagnosis of invasive mucormycosis to guide the timely initiation of amphotericin B and possible surgical intervention, a coordinated multidisciplinary approach of clinical assessment, diagnostic imaging, and laboratory assessment is necessary. Laboratory assessment for mucormycosis includes the conventional methods of direct examination and culture of tissue, respiratory secretions, bronchoalveolar lavage fluid, and other fluids. However, because conventional diagnostic tools are limited in their sensitivity, advanced molecular amplification systems, antigen detection assays, proteomic profiles, and metabolite detection may complement existing approaches to improve the rate of early diagnosis of invasive mucormycosis.

Pulmonary mucormycosis (PM), a life-threatening infection caused by Mucorales , exhibits high mortality. Comprehensive data integrating clinical profiling, antifungal susceptibility, and biofilm formation ability are limited. This retrospective study characterized 26 adult PM patients at a Beijing tertiary-care hospital. Data on demographics, underlying diseases, co-infections, and outcomes were collected. Clinical Mucorales isolates underwent molecular identification via 18 S rRNA gene sequencing and phylogenetic analysis. In vitro susceptibility against nine antifungals (amphotericin B, fluconazole, voriconazole, itraconazole, posaconazole, caspofungin, micafungin, anidulafungin, 5-flucytosine) was determined using Sensititre YeastOne YO10 panels. Biofilm biomass was assessed (24 h, 48 h, 72 h) via the crystal violet staining assay. Patients were predominantly older males (median age 66 years, 65.4% male) with high comorbidity burden (92.3%). All-cause in-hospital mortality was 38.5%. Strikingly, 80.8% had co-infections. Temporal analysis revealed that viral (77.8%) and fungal (62.5%) co-infections often preceded the detection of Mucorales . Molecular identification confirmed Rhizopus spp. (54%) predominated, followed by Rhizomucor spp. (19%), Mucor spp. (19%), and Lichtheimia spp. (8%). Antifungal testing showed amphotericin B possessed the most consistent activity (MIC 50 /MIC 90 : 1/2 µg/mL). Posaconazole was the most potent azole (MIC 50 /MIC 90 : 0.25/1 µg/mL), but profound genus-level heterogeneity was observed. Biofilm assessment at the 48-h peak revealed biofilm formation in 84.6% (22/26) of isolates. This study highlights the high prevalence of antecedent viral/fungal co-infections preceding Mucorales detection and significant mortality, despite in vitro susceptibility to amphotericin B/posaconazol. In addition, most of the strains demonstrated biofilm formation ability, with evident genus-level heterogeneity. These findings emphasize the imperative of species-level identification and consideration of genus-specific traits to guide effective management of this life-threatening infection.

The order Mucorales is a group of ancient fungi with limited tools for gene manipulation. The main consequence of this manipulation unwillingness is the limited knowledge about its biology compared to other fungal groups. However, the emerging of mucormycosis, a fungal infection caused by Mucorales, is attracting the medical spotlight in recent years because the treatments available are not efficient in reducing the high mortality associated with this disease. The result of this renewed interest in Mucorales and mucormycosis is an extraordinarily productive effort to unveil their secrets during the last decade. In this review, we describe the most compelling advances related to the genetic study of virulence factors, pathways, and molecular mechanisms developed in these years. The use of a few genetic study models has allowed the characterization of virulence factors in Mucorales that were previously described in other pathogens, such as the uptake iron systems, the mechanisms of dimorphism, and azole resistances. More importantly, recent studies are identifying new genes and mechanisms controlling the pathogenic potential of Mucorales and their interactions with the host, offering new alternatives to develop specific strategies against mucormycosis.

The order Mucorales is an ancient group of fungi classified in the subphylum Mucoromycotina. Mucorales are mainly fast-growing saprotrophs that belong to the first colonizers of diverse organic materials and represent a permanent part of the human environment. Several species are able to cause human infections (mucormycoses) predominantly in patients with impaired immune system, diabetes, or deep trauma. In this review, we compiled 32 reports on community- and hospital-acquired outbreaks caused by Mucorales. The most common source of mucoralean outbreaks was contaminated medical devices that are responsible for 40.7% of the outbreaks followed by contaminated air (31.3%), traumatic inoculation of soil or foreign bodies (9.4%), and the contact (6.2%) or the ingestion (6.2%) of contaminated plant material. The most prevalent species were Rhizopus arrhizus and R.   microsporus causing 57% of the outbreaks. The genus Rhizomucor was dominating in outbreaks related to contaminated air while outbreaks of Lichtheimia species and Mucor circinelloides were transmitted by direct contact. Outbreaks with the involvement of several species are reported. Subtyping of strains revealed clonality in two outbreaks and no close relation in two other outbreaks. Based on the existing data, outbreaks of Mucorales can be caused by heterogeneous sources consisting of different strains or different species. Person-to-person transmission cannot be excluded because Mucorales can sporulate on wounds. For a better understanding and prevention of outbreaks, we need to increase our knowledge on the physiology, ecology, and population structure of outbreak causing species and more subtyping data.

Purpose The incidence of Mucormycosis has increased during the last decades globally due to more patients being at risk for these life-threatening infections. Early diagnosis and proper selection of appropriate antifungal therapy are vital in enhancing patient outcomes. Mucorales species present a significant challenge due to their resistance to many drugs, so investigations for new therapies and strategies must be undertaken. This study elucidates the distribution and antifungal susceptibility profiles of Mucorales isolates from Iran over five years. Methods Species identification was performed based on morphological features and Internal Transcribed Spacer (ITS) sequences analysis. Antifungal susceptibility testing for commonly used antifungal agents was conducted following CLSI M38-A3 broth microdilution. Results One hundred eighty-one (116 clinical and 65 environmental) isolates were analyzed. Rhizopus arrhizus (67.9%, n  = 123) and Mucor circinelloides (23.2%, n  = 42) were the predominant species. The various clinical samples analyzed included sinus biopsies, nasal secretions, orbital tissues, maxilla tissues, throat, and brain tumors. Conclusion The lowest geometric mean minimum inhibitory concentration values were observed against the clinical and environmental isolates for amphotericin B, posaconazole, and isavuconazole. Understanding Mucorales' distribution and antifungal susceptibility patterns helps clinicians select antifungal therapies. However, further studies are warranted to correlate these findings with clinical outcomes.

Fungi of the order Mucorales cause mucormycosis, a lethal infection with an incompletely understood pathogenesis. We demonstrate that Mucorales fungi produce a toxin, which plays a central role in virulence. Polyclonal antibodies against this toxin inhibit its ability to damage human cells in vitro and prevent hypovolemic shock, organ necrosis and death in mice with mucormycosis. Inhibition of the toxin in Rhizopus delemar through RNA interference compromises the ability of the fungus to damage host cells and attenuates virulence in mice. This 17 kDa toxin has structural and functional features of the plant toxin ricin, including the ability to inhibit protein synthesis through its N -glycosylase activity, the existence of a motif that mediates vascular leak and a lectin sequence. Antibodies against the toxin inhibit R. delemar- or toxin-mediated vascular permeability in vitro and cross react with ricin. A monoclonal anti-ricin B chain antibody binds to the toxin and also inhibits its ability to cause vascular permeability. Therefore, we propose the name ‘mucoricin’ for this toxin. Not only is mucoricin important in the pathogenesis of mucormycosis but our data suggest that a ricin-like toxin is produced by organisms beyond the plant and bacterial kingdoms. Importantly, mucoricin should be a promising therapeutic target. Mucorales fungi produce a ricin-like toxin, mucoricin, which is required for fungal pathogenesis and represents a potential therapeutic target.

Abstract The Mucorales fungal genus Rhizopus is used for the industrial production of organic acids, enzymes and fermented foods. The metabolic engineering efficiency of Rhizopus could be improved using gene manipulation; however, exogenous DNA rarely integrates into the host genome. Consequently, a genetic tool for Mucorales fungi needs to be developed. Recently, programmable nucleases that generate DNA double-strand breaks (DSBs) at specific genomic loci have been used for genome editing in various organisms. In this study, we examined gene disruption in Rhizopus oryzae using transcription activator-like effector nucleases (TALENs), with and without exonuclease overexpression. TALENs with an overexpressing exonuclease induced DSBs, followed by target site deletions. Although DSBs are repaired mainly by nonhomologous end joining in most organisms, our results suggested that in R. oryzae microhomology-mediated end joining was the major DSB repair system. Our gene manipulation method using TALENs coupled with exonuclease overexpression contributes to basic scientific knowledge and the metabolic engineering of Rhizopus. Gene disruption was achieved in Rhizopus oryzae using Platinum TALEN (transcription activator-like effector nuclease) with newly identified exonuclease that stimulated microhomology-mediated end joining.

Results of recording of four species of Mucorales from Poland are given.

In May 2011, a tornado struck Joplin, Missouri. A cluster of mucormycosis infections was identified in 13 patients injured during the tornado. All cases were associated with penetrating trauma. Mucormycosis (formerly known as zygomycosis) is a rare infection caused by molds belonging to the subphylum Mucoromycotina in the order Mucorales. 1 These fungi are ubiquitous in nature, particularly in soil, decaying wood, and other organic matter. 2 Mucormycetes have an affinity for iron-rich, acidic environments; iron-overload states and acidemia are risk factors for infection. 3 A classic feature of mucormycosis is tissue necrosis as a result of vascular invasion and subsequent thrombosis. 3 , 4 Although mucormycosis predominantly affects immunocompromised persons, cutaneous mucormycosis may also occur after trauma in immunocompetent persons. 4 – 6 On May 22, 2011, a tornado rated EF-5 (the highest category on . . .