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A decade of change: evolving epidemiology of invasive pulmonary mold infections in hematologic malignancy patients

Guy Handley1,2, Jane Powell2, Dimitrios P Kontoyiannis1

  • 1https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Infection Control and Hospital Epidemiology
|April 21, 2026
PubMed

Insights

Pulmonary mold infections show changing trends. Aspergillus decreased in late-onset cases, while Fusarium spp. infections significantly increased, indicating a shift in fungal pathogens.

Area of Science:

  • Medical Mycology
  • Infectious Diseases Epidemiology

Background:

  • Pulmonary mold infections pose a significant clinical challenge.
  • Understanding evolving epidemiologic trends is crucial for effective management.

Purpose of the Study:

  • To assess the changing epidemiologic trends of pulmonary mold infections.
  • To identify shifts in the prevalence of specific fungal pathogens over time.

Main Methods:

  • Retrospective analysis of 227 pulmonary mold infection cases.
  • Comparison of infection onset timing (early vs. late-onset).
  • Statistical analysis to compare pathogen frequency between different time periods (2014-2019 vs. 2020-2025).

Main Results:

  • Aspergillus was less common in late-onset infections compared to early-onset infections (58.3% vs 78.3%).
  • A dramatic decrease in Aspergillus frequency was observed in late-onset cases from 2020-2025 compared to 2014-2019 (11.1% vs 86.7%).
  • Fusarium spp. infections significantly increased in late-onset cases during 2020-2025 compared to 2014-2019 (44.4% vs 0%).

Conclusions:

  • Late-onset pulmonary mold infections demonstrate a significant shift in causative agents.
  • There is a concerning rise in Fusarium spp. and a decline in Aspergillus in late-onset cases.
  • These findings necessitate re-evaluation of diagnostic and therapeutic strategies for pulmonary mycoses.

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