Identification and susceptibility of Rhizomucor spp. isolated from patients with cutaneous zygomycosis in China.

Zygomycosis is a relatively uncommon mycosis with a morbidity that is increasing worldwide. Cutaneous zygomycosis, one of the clinical manifestations of the disease, has also emerged in recent decades. The major reported etiologic agents in China include Rhizomucor spp., Rhizopus spp., Mucor spp., and Lichtheimia spp. (formerly Absidia spp.). This study examined 11 clinical isolates of Rhizomucor that belong to three species (R. variabilis, R. regularior, and R. chlamydosporus). They were identified by both morphological and molecular methods and were found to have a high degree of correlation. In vitro susceptibility of the Rhizomucor isolates to seven antifungal drugs (amphotericin B, itraconazole, terbinafine, voriconazole, fluconazole, flucytosine, and micafungin) were tested, which resulted in amphotericin B being found to be the most active agent against all species evaluated in this study. The investigation also reviewed case reports of cutaneous zygomycosis in China.