The model will be robustly developed from a large database of multiple host factors, clinical manifestations, diagnostic imaging and antifungal agents. A risk scorecard will be developed that will allow physicians worldwide to identify patients who are at greatest risk for development of mucormycosis. Categorical variables will be analysed by Fisher’s exact test, and continuous Target Selective Inhibitor Library price variables by Mann–Whitney U-test.

Logistic regression will be used to identify variables independently associated with development of mucormycosis. Survival will be plotted by Kaplan–Meier analysis and analysed by Mantel–Haenszel chi-square (log rank test). A separate logistic regression model will be developed for mortality. All variables associated in the bivariate analysis will be

included in the model at a threshold of P < 0.1. A stepwise logistic approach will be used to identify independent predictors of mortality. The final models will contain variables at the threshold of P < 0.05. This prospective cohort study will use propensity-matched analyses to control for underlying comorbidities and prognostic imbalances in the determination of attributable mortality, length of stay and hospital charges associated with mucormycosis. Control patients will be matched 2 : 1 against diagnostic cases with control for age, gender selleck chemicals and underlying disease process. Identification of the Mucorales to the level of genus and species depends upon colonial morphology, microscopic morphology and growth temperature. Most medically important Mucorales are thermotolerant and grow rapidly at temperatures ≥37 °C. Microscopic characterisation of non-septate hyphae, rhizoids, columellae, sporangia and sporangiospores help to define genus and species within the order Mucorales.[13] Rhizopus oryzae is the most commonly reported single species.[1] Less 4��8C common Rhizopus species include

Rhizopus rhizopodiformis and Rhizopus microsporus. The genus Mucoris the second most commonly reported with Mucor circinelloides being the most common species. Less common species include Cunninghamella bertholletiae, Apohysomyces elegans and L. corymbifera. Since identification of the Mucorales to the genus or species level carries important epidemiological, therapeutic and prognostic significance, accurate identification of the Mucorales is important. While R. oryzae is the most common organism among the Mucorales recovered from clinical specimens, it tends to have relatively high minimum inhibitory concentrations (MICs) of posaconazole; whereas, M. circinelloides is less commonly isolated but more susceptible to posaconazole. Cunninghamella tends to have higher AmB MICs, relatively low posaconazole MICs, and a higher associated overall mortality compared to other species. Essential to the study of the relationship between species and outcome is accurate identification of infecting organisms.