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The Epidemiology of Fungal Infections

Fungal infections may be divided into two categories: nosocomial and community-associated.

Nosocomial fungal infections are defined as those acquired in a healthcare setting and are almost always opportunistic mycoses.

In contrast, community-associated fungal infections include not only opportunistic mycoses but also endemic mycoses,

for which susceptibility to the infection is acquired by living in a geographic area constituting the natural habitat of a pathogenic fungus and possessing risk factors that are predisposing.

Over the past two and a half decades, the incidence of both nosocomial and community-associated fungal infections has increased dramatically.

An analysis of trends in infectious disease mortality in the United States found that fungal infections had risen from the tenth to the seventh most common cause of infectious disease-related mortality between 1980 and 1997.1

Numerous factors have contributed to the increase in fungal infections, most notably a growing population of immunosuppressed or immunocompromised patients whose mechanisms of host defense have been impaired by primary disease states (e.g., AIDS, cancer),

a mobile and aging population with an increased prevalence of chronic medical conditions, and the use of new and aggressive medical and surgical therapeutic strategies,

including broad-spectrum antibiotics, cytotoxic chemotherapies, and organ transplantation.

Nosocomial fungal infections Increasing incidence and mortality

For the past two decades, hospitals have been experiencing increasing problems with nosocomial fungal infections.

2-5 A recent study of the epidemiology of sepsis found that the annual number of cases of sepsis caused by fungal organisms in the United States increased by 207% between 1979 and 2000.

In the Surveillance and Control of Pathogens of Epidemiological Importance Study, a 49-center study of 24,179 nosocomial bloodstream infections recorded between 1995 and 2002, 9.5% of the infections were fungal in origin. Candida spp.

were the fourth leading cause of nosocomial bloodstream infections, surpassed only by staphylococci and enterococci (Table 1-1).

Author
Language English
No. of Pages674
PDF Size93.9 MB
CategoryAstrology

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