[Epidemiology of invasive fungal disease by filamentous fungi in the period 2005 to 2015, in a university hospital in Santiago, Chile]

Rev Chilena Infectol. 2019 Dec;36(6):732-741. doi: 10.4067/S0716-10182019000600732.
[Article in Spanish]

Abstract

Background: Invasive fungal disease (IFD) due to filamentous fungi is increasingly common.

Aim: To study the epidemiology of EFI in hospitalized adults in our center.

Methods: Retrospective study of adult patients of a university hospital in Santiago, Chile, with EFI due to filamentous fungi between January 2005 and December 2015.

Results: 125 episodes were identified, being 48% proven, 40% probable and 11% possible according to EORTC/MSG criteria, overall incidence was 0.47/1,000 admissions, 57% male patients and age 50 ± 16 years. 66.4% had hematological pathology, 11.2% solid organ transplant, 11.2% rheumatology diseases, 11.2% other conditions. The risk factors were neutropenia 44%, corticosteroid therapy 21%, immunosuppressants 13%. The most frequent mould identified were Aspergillus spp (53.6%), Mucorales (16%), Fusarium spp (8.8%), Alternaria spp (5.6%) and other filamentous (3.2%). All received antifungals, 82% monotherapy, 18% combined therapy, there was surgical defocation in 90% of mucormycosis. The overall mortality was 42%. When comparing 2005-2009 vs 2010-2015, there was a significant increase in incidence and a tendency to lower mortality in the second period.

Conclusions: Over a period of 10 years, we observed an increase in the incidence of EFI by filamentous, aspergillosis was the most frequent etiology and the overall mortality was 42%.

MeSH terms

  • Adult
  • Aged
  • Antifungal Agents / therapeutic use
  • Aspergillosis* / drug therapy
  • Chile / epidemiology
  • Female
  • Fungi
  • Humans
  • Invasive Fungal Infections* / drug therapy
  • Invasive Fungal Infections* / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Antifungal Agents