The order Mucorales is an ancient group of fungi classified in the subphylum Mucoromycotina. Mucorales are mainly fast-growing saprotrophs that belong to the first colonizers of diverse organic materials and represent a permanent part of the human environment. Several species are able to cause human infections (mucormycoses) predominantly in patients with impaired immune system, diabetes, or deep trauma. In this review, we compiled 32 reports on community- and hospital-acquired outbreaks caused by Mucorales. The most common source of mucoralean outbreaks was contaminated medical devices that are responsible for 40.7% of the outbreaks followed by contaminated air (31.3%), traumatic inoculation of soil or foreign bodies (9.4%), and the contact (6.2%) or the ingestion (6.2%) of contaminated plant material. The most prevalent species were Rhizopus arrhizus and R. microsporus causing 57% of the outbreaks. The genus Rhizomucor was dominating in outbreaks related to contaminated air while outbreaks of Lichtheimia species and Mucor circinelloides were transmitted by direct contact. Outbreaks with the involvement of several species are reported. Subtyping of strains revealed clonality in two outbreaks and no close relation in two other outbreaks. Based on the existing data, outbreaks of Mucorales can be caused by heterogeneous sources consisting of different strains or different species. Person-to-person transmission cannot be excluded because Mucorales can sporulate on wounds. For a better understanding and prevention of outbreaks, we need to increase our knowledge on the physiology, ecology, and population structure of outbreak causing species and more subtyping data.

中文翻译：

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毛霉菌的爆发和相关物种

Mucorales 是一类古老的真菌，属于毛霉菌亚门。Mucorales 主要是快速生长的腐生菌，属于多种有机材料的第一批殖民者，代表人类环境的永久组成部分。有几个物种能够引起人类感染（毛霉菌病），主要是在免疫系统受损、糖尿病或深部创伤的患者中。在这篇综述中，我们汇编了 32 份关于毛霉菌引起的社区和医院获得性暴发的报告。mucoralean 暴发最常见的来源是受污染的医疗器械，占暴发的 40.7%，其次是受污染的空气 (31.3%)、土壤或异物的外伤性接种 (9.4%) 以及接触者 (6.2%) 或摄入 (6.2%) 受污染的植物材料。最流行的物种是根茎根霉和小孢子菌，造成 57% 的爆发。根毛霉属在与污染空气有关的暴发中占主导地位，而地衣菌属和圆环毛霉的暴发则通过直接接触传播。据报道，有几种物种参与的爆发。菌株的亚型显示在两次暴发中具有克隆性，而在另外两次暴发中没有密切关系。根据现有数据，毛霉菌爆发可能是由不同菌株或不同物种组成的异质来源引起的。不能排除人与人之间的传播，因为毛霉菌可以在伤口上形成孢子。为了更好地了解和预防疫情爆发，我们需要增加对生理学、生态学、