The burden of serious fungal infection in Israel

Ref ID: 19215

Author:

R. Ben-Ami*, D.W. Denning

Author address:

Manchester, GB

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Objectives: Estimates of fungal infection caseloads are required to plan and implement healthcare policies. In Israel, healthcare is universal, and specialized medical care is centralized in 5 tertiary-level medical centers. A growing medical tourism industry and immigration from Africa have contributed to an increase in the population of patients cared at tertiary hospitals, as well as newly diagnosed TB and HIV/AIDS. We aimed to estimate national fungal infection caseloads from epidemiological datasets.
Methods: We searched national data available from the Israeli ministry of health, WHO and OECD reports, as well as surveillance studies published by us and other authors for relevant disease terms. Locally collected incidence data were available for candidaemia, HIV/AIDS, solid organ and stem cell transplantation, TB, asthma, COPD and CF. Generally, disease estimates were conservative as they assumed the lowest incidence rates reported in the literature and focused only on well-defined risk populations.
Results: Israel’s population in 2011 was 7.8 M (50% female, median age 29 yrs, 34% <=18 yrs, 10% =>65 yrs). Twenty percent of Israelis were smokers, 20% of whom (312,000) had COPD. 375,000 people were living with asthma, and 468 persons had CF. 6,579 persons were living with HIV/AIDS, and 70% of those were receiving antiretroviral treatment. Nationwide surveillance detected a candidaemia rate of 5.5/100,000 population/yr (429/yr), with a crude in-hospital mortality rate of 49%. Conservative estimates of oral and oesophageal candidiasis incidence were 1,776 and 625 cases/yr, respectively. Recurrent vulvovaginal candidiasis (=>4 episodes/yr) occurred at a conservative estimate in 130,000 women/yr. Cases of invasive aspergillosis were estimated at 130/yr, and mucormycosis at 20/yr. ABPA was estimated in 7,945 persons, and SAFS in 12,375 persons. Based on TB statistics, the incidence of chronic pulmonary aspergillosis was estimated at 9-75/yr. PCP was diagnosed in ~17 HIV-infected patients/yr. Endemic fungi were reported only sporadically, and were imported in all cases.
Conclusion: The candidaemia rate in Israel is among the highest reported in the literature. Our estimates point to candidaemia and invasive aspergillosis as the leading causes of fungal-associated death, whereas fungal-related morbidity is mainly due to recurrent vulvovaginal candidiasis, SAFS and ABPA. More precise, prospectively reported data are needed to support informed healthcare policymaking.

Abstract Number: P1037

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=162856&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

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