Italian survey on subcutaneous and deep infections by moulds

Invasive fungal infections are an important cause of morbidity and mortality in immunocompromised patients. Improvements in the management of critical care and neoplastic diseases, and development of newer antimicrobial agents have contributed to the emergence of new fungi and the resurgence of older.The Medical Mycology Division (CoSM) of the Associazione Microbiologi Clinici Italiani (AMCLI) proposed the institution of 1. a national register (2006-2008) of all cases of infection by uncommon moulds, implicated as aethiological agents in subcutaneous and deep mycoses and 2. a fungal library, to perform in vitro epidemiological typing.The strains isolated at each Laboratory have been identified by the means of standard procedures and confirmed by sequencing a fragment encoding the ribosomal large subunit RNA and by comparing in the GenBank. 14 Italian Centers sent 87 strains. The survey confirmed Aspergillus (36/87), Fusarium (17/87), zigomycetes (15/87), dematiaceous (12/87), Histoplasma capsulatum var. capsulatum (3/87) and other jaline moulds (3/87). Sequencing can be considered a confirmatory technique only for unusual moulds difficult to identify.