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Non-HIV populations show high burden of invasive fungal infections
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Invasive fungal infections occur in a wide range of non-HIV-infected patients and should be viewed as an important public health priority, according to a report published in Emerging Infectious Diseases.
In a population-based study, researchers characterized the pathogenesis and patterns of invasive fungal infections in France between 2001 and 2010. They evaluated the prevalence, risk factors and rates of in-hospital mortality of the most commonly reported invasive fungal infections in the national hospital database during the study interval.
Annual incidence rates among the general population were expressed as cases per 100,000 population, using 1999 census data.
They identified 35,876 cases of invasive fungal infections, which included candidemia (43.4%), Pneumocystis jirovecii pneumonia (26.1%), invasive aspergillosis (23.9%), cryptococcosis (5.2%) and mucormycosis (1.5%). There was an overall incidence rate of 5.9/100,000 population per year, with a mortality rate of 27.6%. Both rates represented increases over the study interval, with overall incidence increasing by 1.5% per year and mortality increasing by 2.9% per year.
Rates of candidemia, invasive aspergillosis and mucormycosis increased substantially while Pneumocystis jirovecii pneumonia decreased among patients with AIDS (14.3% decrease per year) but increased in non-HIV-infected patients (increase of 13.3% per year). Patients with hematologic malignancies demonstrated increases in candidemia and invasive aspergillosis infections (more than 4% increase per year); the population of patients with chronic renal failure also experienced increased prevalence of these two infections.
“[Invasive fungal infections] in this study occurred among a broad spectrum of patients and the fatality rate was high; clinicians should be made aware of risk factors, signs and symptoms,” the researchers wrote. “Beyond the specific issues addressed by our study, such as the identification and management of patients in potentially under-recognized risk groups, the expected consequences of the increasing incidence of [invasive fungal infections] should be anticipated in terms of hospital and laboratory workload, antifungal use, and the need for new systemic antifungal drugs and strategies.”
Disclosure: The researchers report no relevant financial disclosures.
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