Fungal epidemiology

Ref ID: 19450

Author:

R. Krause

Author address:

Section of Infectious Diseases and Tropical Medicine, Medical
University of Graz, Austria

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

The incidence of invasive fungal infections (IFIs) has increased signifi-
cantly worldwide, representing an important infective complication
especially in patients at the intensive care unit (ICU) (1,2,3). As previ-
ously shown survival outcome is influenced by early and adequate
antifungal therapy. Knowledge regarding fungal epidemiology is there-
fore important for selection of appropriate calculated and as well as
directed antifungal therapy, e.g. in patients with risk factors for and
suspicion of IFIs, in patients with positive fungal biomarkers or in
patients with pending identification down to the species level of positive
fungal cultures. Candida species are important nosocomial pathogens
in critically ill patients and are associated with substantial mortality
and prolonged hospitalization in the intensive care unit. Candida albicans
accounts for the majority of cases with candidemia, but an
increasing number of infections due to non-albicans spp. have been
reported (4,5). In one study from Greece 64% of candidemic patients
had Candida albicans and 36% had non-albicans strains; Candida
glabrata, C. tropicalis, C. parapsilosis, C. lusitaniae, C. krusei and C. du-
bliensis were found in the non-albicans group (3). However, the distri-
bution of Candida isolates in a given ICU population is influenced by
numerous factors including e.g. geographic localisation, comorbitities,
presence or absence of foreign bodies, duration of hospital stay, age,
and presence of absence of previous antifungal therapy (6). Further-
more, fungal epidemiology is dynamic since in some areas shifts in dis-
tribution of Candida species was noted (6). While Candida species are
the leading pathogens in IFIs in the ICU Aspergillus species are emerg-
ing pathogens in this patient group. Beside patients with major risk
factors for invasive Aspergillosis (haematooncological diseases, neutro-
penia, lung or liver transplantation) this type of IFI has also been found
in patients with multiple organ dysfunctions, immunosuppression in
severe sepsis, high dose steroid therapy, chronic obstructive pulmonary
disease malnutrition and prolonged ICU stay (7). Rarely Mucormycosis is
diagnosed in patients treated in ICUs, mainly occuring in patients with
cancer, diabetes mellitus or iron overload (8). Some other IFIs has
reported in ICU patients, including cryptococcosis, endemic fungal dis-
eases like histoplasmosis, fungal infections in near-drowning accidents or
in patients associated with contaminated methyprednisolone injections.

Abstract Number: w06-1

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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