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Population-based analysis of invasive fungal infections, France, 2001-2010
Abstract:
To determine the epidemiology and trends of invasive fungal infections (IFIs) in France, we analyzed incidence, risk factors, and in-hospital death rates related to the most frequent IFIs registered in the national hospital discharge database during 2001-2010. The identified 35,876 IFI cases included candidemia (43.4%), Pneumocystis jirovecii pneumonia (26.1%), invasive aspergillosis (IA, 23.9%), cryptococcosis (5.2%), and mucormycosis (1.5%). The overall incidence was 5.9/100,000 cases/year and the mortality rate was 27.6%; both increased over the period (+1.5%, +2.9%/year, respectively). Incidences substantially increased for candidemia, IA, and mucormycosis. Pneumocystis jirovecii pneumonia incidence decreased among AIDS patients (-14.3%/year) but increased in non-HIV-infected patients (+13.3%/year). Candidemia and IA incidence was increased among patients with hematologic malignancies (>+4%/year) and those with chronic renal failure (>+10%/year). In-hospital deaths substantially increased in some groups, e.g., in those with hematologic malignancies. IFIs occur among a broad spectrum of non-HIV-infected patients and should be a major public health priority.
Insights
Invasive fungal infections (IFIs) are rising in France, particularly candidemia and invasive aspergillosis. These infections affect many non-HIV patients, highlighting a significant public health concern.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Invasive fungal infections (IFIs) pose a significant threat, with trends and risk factors requiring ongoing surveillance.
- Understanding the epidemiology of IFIs is crucial for effective public health strategies.
Purpose of the Study:
- To analyze the epidemiology and trends of major IFIs in France from 2001 to 2010.
- To identify risk factors and in-hospital mortality rates associated with common IFIs.
Main Methods:
- Analysis of a national hospital discharge database covering 35,876 IFI cases.
- Examination of incidence, risk factors, and mortality for candidemia, Pneumocystis jirovecii pneumonia, invasive aspergillosis, cryptococcosis, and mucormycosis.
Main Results:
- Overall IFI incidence was 5.9/100,000 cases/year, with a 27.6% mortality rate, both increasing over the study period.
- Significant incidence increases were observed for candidemia, invasive aspergillosis, and mucormycosis.
- Pneumocystis jirovecii pneumonia incidence decreased in AIDS patients but rose in non-HIV patients; candidemia and invasive aspergillosis rose in hematologic malignancy and chronic renal failure patients.
Conclusions:
- Invasive fungal infections are increasingly prevalent in France, affecting a wide range of non-HIV-infected patients.
- The rising incidence and mortality underscore the need to prioritize IFIs as a major public health issue.
- Specific patient groups, including those with hematologic malignancies and chronic renal failure, face heightened risks.
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