The aims of the WG were to form

a European registry, collecting cases of mucormycosis from various European countries. During the period 2005–2007, 230 cases were submitted from 13 countries.[6] While this study and others studies have characterised risk factors DAPT in vitro for mortality in mucormycosis, there is no reported contemporary, international, case–controlled study of the epidemiological, metabolic and immunological risk factors for mucormycosis that would facilitate early clinical diagnosis. The newly configured ZWG2 markedly expands the number of participating centres and countries and is now known as the ECMM/ISHAM WG. The database will be migrated to the auspices of the Infection Control Program at ELPIDA in Athens, Greece. The portal for remote data entry will remain http://www.zygomyco.net/. For the first time, infected patients and two contemporaneous case–controls will be included prospectively. Prognostic variables will also be built into the new database for infected patients and non-infected controls. The database will now include multiple expanded and risk variables with high levels of quantitative refinements summarised in Table 1. The new database will establish for the first time an international profile for the epidemiology,

clinical manifestations, risk factors and outcome of mucormycosis. Denominators will be established for select groups of underlying conditions, particularly leukaemia and allogeneic HSCT Lepirudin in order to provide a marker for incidence. NVP-LDE225 cell line These two populations are most readily tracked in institutions. All participating investigators will enrol infected patients and two contemporaneous controls who will be followed through the duration of treatment and for 6 month follow-up for a total duration of 1 year, whichever

is shorter. All cases of mucormycosis entered through Fungiscope (http://www.fungiquest.net/) will be shared with the ZWG2 study. Concurrent untreated controls will be identified for these cases by the investigator enrolling the patient with mucormycosis. Early identification of host factors is an important strategy for assessment of the Bayesian prior probability of a patient’s risk for invasive mucormycosis. The classic host factors for mucormycosis are diabetic ketoacidosis and profound and persistent neutropenia. However, not all patients with diabetic ketoacidosis or profound and persistent neutropenia develop mucormycosis. Additional data are required to understand risk factors in these populations. Moreover, other host groups, including those with allogeneic HSCT, type 2 diabetes, low birth weight infants, burns and trauma, solid organ transplantation, autoimmune disorders and illicit intravenous drug use are also at risk (Table 2). Identification of certain clinical manifestations in association with risk factors may further refine early diagnostic accuracy and predictive power.

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