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Epidemiology of nosocomial fungal infections
1Section of Infectious Disease, Rush Medical College/Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
Abstract:
This paper briefly reviews the current knowledge of the epidemiology and modes of transmission of nosocomial fungal infections and some of the therapeutic options for treating these diseases. In the mid-1980s, many institutions reported that fungi were common pathogens in nosocomial infections. Most, if not all, hospitals care for patients at risk for nosocomial fungal infections. The proportion in all nosocomial infections reportedly caused by Candida spp. increased from 2% in 1980 to 5% in 1986 to 1989. Numerous studies have identified common risk factors for acquiring these infections, most of which are very common among hospitalized patients; some factors act primarily by inducing immunosuppression (e.g., corticosteroids, chemotherapy, malnutrition, malignancy, and neutropenia), while others primarily provide a route of infection (e.g., extensive burns, indwelling catheter), and some act in combination. Non-albicans Candida spp., including fluconazole-resistant C. krusei and Torulopsis (C.) glabrata, have become more common pathogens. Newer molecular typing techniques can assist in the determination of a common source of infection caused by several fungal pathogens. Continued epidemiologic and laboratory research is needed to better characterize these pathogens and allow for improved diagnostic and therapeutic strategies.
Insights
Nosocomial fungal infections are a growing concern in hospitals, with Candida species increasing as a cause. Understanding transmission and risk factors is crucial for effective treatment and prevention strategies.
Area of Science:
- Medical Mycology
- Infectious Diseases Epidemiology
Background:
- Nosocomial fungal infections are increasingly recognized as significant hospital-acquired illnesses.
- Candida species have risen as common pathogens, with their proportion in nosocomial infections rising from 2% in 1980 to 5% by 1986-1989.
- Patients in most hospitals are at risk due to common risk factors like immunosuppression and invasive procedures.
Purpose of the Study:
- To review current knowledge on the epidemiology and transmission of nosocomial fungal infections.
- To discuss therapeutic options for these infections.
- To highlight the emergence of non-albicans Candida species and the need for further research.
Main Methods:
- Literature review of epidemiological studies on nosocomial fungal infections.
- Analysis of trends in the prevalence of Candida species.
- Discussion of identified risk factors and therapeutic approaches.
Main Results:
- Fungal pathogens, particularly Candida species, are common causes of nosocomial infections.
- Risk factors include immunosuppression (e.g., chemotherapy, corticosteroids) and breaches in infection control (e.g., catheters, burns).
- Non-albicans Candida species, including fluconazole-resistant strains like Candida krusei and Candida glabrata, are emerging pathogens.
Conclusions:
- Effective management requires understanding transmission routes and risk factors.
- Emerging drug-resistant fungal strains necessitate ongoing research for better diagnostics and therapeutics.
- Molecular typing aids in identifying infection sources and controlling outbreaks.