{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T09:33:07Z","timestamp":1772789587681,"version":"3.50.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mucormycosis is a life-threatening invasive fungal infection that mainly affects individuals with weakened immune systems. Despite its clinical importance, data from T\u00fcrkiye on the epidemiology and antifungal susceptibility of fungi belonging to the order Mucorales are scarce. This study aimed to describe the clinical, epidemiological, and mycological features of mucormycosis over a twenty-year period at a tertiary care hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All cases of mucormycosis diagnosed between 2003 and 2022 at Bursa Uluda\u011f University Hospital were retrospectively evaluated. Cases were classified as proven or probable according to international definitions. Molecular identification was based on internal transcribed spacer sequencing. Large subunit ribosomal DNA region sequencing and whole-genome sequencing were performed when necessary. Antifungal susceptibility testing for amphotericin B and posaconazole was performed according to the Clinical and Laboratory Standards Institute M38 guideline. Statistical analyses included chi-square, Fisher\u2019s exact, Spearman\u2019s correlation, and Wilcoxon signed-rank tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 187 cases were identified, comprising 134 proven and 53 probable. Rhino-cerebral infection was the most frequent form, followed by pulmonary disease. Hematologic malignancy was the most common underlying condition, and mortality was 52.9 percent. Molecular identification was achieved for 99 isolates, with\n                      <jats:italic>Rhizopus arrhizus<\/jats:italic>\n                      predominant and\n                      <jats:italic>Rhizomucor pusillus<\/jats:italic>\n                      second. Posaconazole exhibited greater\n                      <jats:italic>in vitro<\/jats:italic>\n                      activity than amphotericin B (p &amp;lt; 0.001), while\n                      <jats:italic>Cunninghamella<\/jats:italic>\n                      species showed elevated amphotericin B minimum inhibitory concentrations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This single-center study provides the most comprehensive data on mucormycosis in T\u00fcrkiye and highlights the importance of molecular surveillance to guide antifungal therapy and monitor regional variations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1771517","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:44:26Z","timestamp":1772779466000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Two decades of mucormycosis: molecular epidemiology and antifungal susceptibility trends in T\u00fcrkiye"],"prefix":"10.3389","volume":"16","author":[{"given":"Ay\u015fen","family":"\u0130kkan","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osman","family":"Merdan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Se\u00e7il","family":"Ak-Aksoy","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeinep Chavouz","family":"Ametoglou","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0130mran","family":"Sa\u011fl\u0131k","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hazel","family":"\u00d6zt\u00fcrk-Belik","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u00fc\u015fra","family":"\u00c7al\u0131\u015f\u0131r","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d6zlem","family":"Saraydaro\u011flu","sequence":"additional","affiliation":[{"name":"Department of Medical Pathology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samet","family":"K\u0131z\u0131l","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beyhan","family":"B\u00fclb\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Paediatric Infectious Diseases, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esra","family":"Kazak","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beyza","family":"Ener","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Bursa Uluda\u011f University","place":["Bursa, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.1128\/AAC.01467-08","article-title":"Activity of posaconazole and other antifungal agents against Mucorales strains identified by sequencing of internal transcribed spacers","volume":"53","author":"Alastruey-Izquierdo","year":"2009","journal-title":"Antimicrob. 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