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Epidemiology and control of fungal infections
1Department of Pathology, University of Iowa College of Medicine, Iowa City 52242.
Abstract:
The increase in the frequency of fungal infections over the past decade is significant. This increase has particularly occurred among patients in hospitals, where the rate of candidal bloodstream infection has increased by as much as 487% throughout the decade of the 1980s. This increased frequency of infection has been accompanied by significant excess mortality. The documentation of nosocomial transmission of fungal pathogens and the recognition of resistance to antifungal agents pose a significant problem. The fact that the lack of hand washing by patient care providers in intensive care units has been linked to hand carriage of strains of Candida that were isolated from the bloodstream of patients in intensive care units suggests that cross-infection is an important and preventable feature of candidal bloodstream infection. New and more-effective strategies must be developed for prophylaxis of endogenous infections and prevention of transmission within the hospital setting.
Insights
Fungal infections, especially candidal bloodstream infections in hospitals, have surged, leading to increased mortality. Poor hand hygiene among healthcare workers contributes to this preventable cross-infection crisis.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Mycology
Background:
- Significant rise in fungal infections over the past decade.
- Dramatic increase in candidal bloodstream infections (up to 487%) in hospital settings during the 1980s.
- Associated excess mortality and emergence of antifungal resistance.
Purpose of the Study:
- To highlight the growing problem of fungal infections in hospitals.
- To underscore the link between healthcare worker hygiene and nosocomial transmission.
- To advocate for improved prevention strategies.
Main Methods:
- Review of epidemiological trends in fungal infections.
- Analysis of candidal bloodstream infection rates.
- Investigation of nosocomial transmission pathways, including hand carriage by healthcare providers.
Main Results:
- Substantial increase in hospital-acquired fungal infections and associated mortality.
- Identification of poor hand hygiene in intensive care units as a factor in Candida transmission.
- Evidence of cross-infection from healthcare worker hand carriage.
Conclusions:
- Nosocomial transmission of fungal pathogens is a significant and preventable issue.
- Improved hand hygiene is crucial for reducing candidal bloodstream infections.
- Development of new prophylactic and transmission prevention strategies is urgently needed.