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Recent trends in the epidemiology of invasive mycoses
Thomas A Clark1, Rana A Hajjeh
1Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. rhajjeh@cdc.gov
Purpose Of Review:
Invasive mycoses are emerging as an important public health problem. This development has occurred in large measure due to the increasing numbers of persons at risk. In addition, advances in therapeutic technologies and in particular the development of novel immunosuppressive therapies have prolonged the period of risk for many individuals.
Recent Findings:
Although rates of candida bloodstream infections have been increasing over the past several decades, recent evidence suggests this trend may be reversing. The emergence of non-albicans Candida species, and in particular C. glabrata, has been documented. Invasive aspergillosis and other mold infections have become a significant and increasing problem in hematopoietic stem cell transplant recipients and certain high-risk groups of solid organ transplant recipients. These infections are associated with high mortality rates. Despite marked reductions in the rates of AIDS-associated fungal infections in the USA and other developed countries, the burden of these mycoses in developing countries is large and increasing.
Summary:
While gains have been made in the treatment and prevention of invasive mycoses, changes in the epidemiology of these infections and in healthcare practices have resulted in the emergence of new at-risk populations. A better understanding of specific risk factors will be needed if prevention strategies, such as chemoprophylaxis and environmental control measures, are to become more widely applicable and cost-effective.
Insights
Invasive fungal infections are a growing public health concern, driven by increased at-risk populations and novel therapies. Understanding risk factors is crucial for effective prevention strategies.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Public Health
Background:
- Invasive mycoses represent a significant and escalating global health challenge.
- Increased numbers of immunocompromised individuals and advancements in immunosuppressive therapies contribute to this rise.
- The changing landscape of healthcare practices necessitates a re-evaluation of fungal infection risks.
Purpose of the Study:
- To review the current epidemiology of invasive fungal infections.
- To highlight emerging trends and challenges in the management of mycoses.
- To emphasize the need for improved prevention and control strategies.
Main Methods:
- Review of recent scientific literature on invasive mycoses.
- Analysis of epidemiological data and clinical findings.
- Synthesis of information on therapeutic advancements and risk factors.
Main Results:
- While Candida bloodstream infections may be stabilizing, non-albicans Candida species are emerging.
- Invasive aspergillosis and other mold infections pose a significant threat to transplant recipients, with high mortality.
- Fungal infections associated with Acquired Immunodeficiency Syndrome (AIDS) have decreased in developed nations but remain a burden in developing countries.
Conclusions:
- Despite progress in treatment and prevention, new populations are at risk due to evolving epidemiology and healthcare practices.
- Enhanced understanding of specific risk factors is essential for developing cost-effective prevention strategies.
- Chemoprophylaxis and environmental controls require further research for broader application.