毛霉菌病是一种致命的侵袭性真菌感染，最近被列入世界卫生组织优先病原体名单。在这里，我们试图描述法国毛霉菌病的流行病学趋势，并评估与死亡率相关的因素。2012年至2022年，我们在法国实施了全国毛霉菌病前瞻性监测计划，重点关注流行病学、物种和季节变化。采用单变量和多变量logistic回归研究与3个月死亡率相关的因素。 550例毛霉菌病中，主要基础疾病为血液系统恶性肿瘤（HM，65.1％，358/550）、外伤（8％，44/550）、糖尿病（7.5%，41/550）和实体器官移植（6.5%，36/550）。感染部位为肺部（52.4%（288/550））、鼻脑（14.5%（80/550））和皮肤关节（17.1%（94/550））。鉴定出的主要种类为无根根霉 (21%, 67/316)、小孢根霉 (13.6%, 43/316)、伞形毛霉和卷线毛霉 (各 13.3%, 42/316)、微小根毛霉 (12%, 38/316) ) 和 Lichtheimia ramosa (10.8%, 34/316)。我们发现基础疾病、感染部位和感染物种之间存在关联，包括先前未描述的创伤、皮肤关节定位和 L. ramosa/M 的三联征。 卷叶属。聚合酶链式反应 (PCR) 的诊断贡献从 2012 年的 16% (4/25) 增加到 2022 年的 91% (61/67)，2022 年超过 50% 的诊断仅依赖 PCR。我们还发现了季节性变化秋季病例相对较多。 90 天死亡率为 55.8% (276/495)。独立的预后因素是年龄、重症监护病房 (ICU) 的诊断和 HM，而 2015 年之后的诊断（即大规模实施 PCR）和手术与死亡率降低相关。这项研究揭示了法国毛霉菌病流行病学的主要变化，其中毛霉菌病占主导地位HM 患者的研究，以及 PCR 多中心实施与预后改善之间的平行分析。我们还证明了物种、本地化和风险因素以及季节变化之间的新关联。法国公共卫生署和巴斯德研究所的经常性财政支持。© 2024 作者。

Mucormycosis is a deadly invasive fungal infection recently included in the WHO priority pathogen list. Here we sought to describe epidemiological trends of mucormycosis in France, and to evaluate factors associated with mortality.From 2012 to 2022, we implemented a nationwide prospective surveillance programme for mucormycosis in France, focusing on epidemiology, species, seasonal variations. Factors associated with 3-month mortality were studied by univariable and multivariable logistic regression.Among 550 cases of mucormycosis, the main underlying conditions were haematological malignancy (HM, 65.1%, 358/550), trauma (8%, 44/550), diabetes (7.5%, 41/550) and solid-organ transplants (6.5%, 36/550). Site of infection was pulmonary in 52.4% (288/550), rhinocerebral in 14.5% (80/550), and cutaneo-articular in 17.1% (94/550). Main species identified were Rhizopus arrhizus (21%, 67/316), Rhizopus microsporus (13.6%, 43/316), Lichtheimia corymbifera and Mucor circinelloides (13.3%, 42/316 each), Rhizomucor pusillus (12%, 38/316), and Lichtheimia ramosa (10.8%, 34/316). We found associations between underlying condition, site of infection, and infecting species, including a previously undescribed triad of trauma, cutaneo-articular localisations, and L. ramosa/M. circinelloides. Diagnostic contribution of Polymerase Chain Reaction (PCR) increased from 16% (4/25) in 2012 to 91% (61/67) in 2022, with more than 50% of diagnoses relying solely on PCR in 2022. We also found seasonal variations with relatively more cases in autumn. Ninety-day mortality was 55.8% (276/495). Independent prognostic factors were age, diagnosis in Intensive Care Unit (ICU), and HM while diagnosis after 2015 (i.e. large implementation of PCR) and surgery were associated with reduced mortality.This study reveals major mucormycosis epidemiological changes in France, with a large predominance of HM patients, and a parallel between PCR multicentre implementation and improved prognosis. We also evidence new associations between species, localisations and risk factors, as well as seasonal variations.Recurrent financial support from Santé Publique France and Institut Pasteur.© 2024 The Author(s).