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Polymicrobial fungemia: microbiology, clinical features, and significance
L Guerra-Romero1, A Telenti, R L Thompson
1Hospital Severo Ochoa, Leganés, Madrid, Spain.
Abstract:
In a retrospective study covering a period of 13 1/2 years, polymicrobial fungemia was documented in 22 (3.4%) of 645 patients with fungemia. These infections were hospital acquired and occurred in patients with significant underlying diseases. In terms of the clinical setting and features, predisposing factors, fungal species responsible, management, and mortality rate (59%), polymicrobial fungemia appears similar to the more common "monomicrobial" fungemia. With increasing numbers of patients at risk and improved laboratory detection of fungemia, clinicians will probably encounter increasing numbers of these polymicrobial bloodstream infections.
Insights
Polymicrobial fungemia, involving multiple fungi, is a hospital-acquired infection affecting critically ill patients. This bloodstream infection shares similarities with monomicrobial fungemia, including high mortality rates.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Fungal bloodstream infections (fungemia) pose a significant threat, particularly in immunocompromised patients.
- Polymicrobial fungemia, caused by multiple fungal species, is less common but increasingly recognized.
- Identifying risk factors and outcomes for polymicrobial fungemia is crucial for effective patient management.
Purpose of the Study:
- To investigate the incidence, characteristics, and outcomes of polymicrobial fungemia.
- To compare polymicrobial fungemia with monomicrobial fungemia in terms of clinical presentation, management, and mortality.
- To highlight the growing importance of recognizing and managing polymicrobial fungemia in clinical practice.
Main Methods:
- Retrospective analysis of 645 patients with fungemia over a 13.5-year period.
- Documentation and analysis of cases with polymicrobial fungemia (22 cases, 3.4%).
- Comparison of clinical features, predisposing factors, fungal species, management strategies, and mortality rates between polymicrobial and monomicrobial fungemia.
Main Results:
- Polymicrobial fungemia was identified in 3.4% of fungemia cases and was hospital-acquired.
- Patients with polymicrobial fungemia had significant underlying diseases.
- Clinical features, management, and mortality (59%) were similar to monomicrobial fungemia.
Conclusions:
- Polymicrobial fungemia is an emerging challenge in healthcare settings.
- The clinical and epidemiological profile of polymicrobial fungemia mirrors that of monomicrobial fungemia.
- Increased vigilance and improved diagnostic capabilities will likely lead to more frequent identification of these complex infections.