<p>Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern China</p>

Abstract

Introduction: Invasive fungal disease (IFD) is a life-threatening infection. The epidemiology and clinical features of IFD in the elderly population are less discussed. The aim of this study was to explore the epidemiology and mortality-associated factors for IFD in the elderly inpatients. Methods: A retrospective study enrolling 512 elderly inpatients from The First Affiliated Hospital of Sun Yat-sen University during the last two decades was performed. Results: The annual prevalence of IFD was 0.1-0.5%. Candidiasis was the most common (236/521, 45.3%). An increasing trend was observed in aspergillosis from 11.1% in year 1998 to 28.8% in year 2018. The common infective sites of candidiasis were abdominal cavity (83/236, 35.2%) and bloodstream (55/236, 23.3%). Invasive aspergillosis mainly developed in the sinus (74/149, 49.7%) and lung (65/149, 43.6%). Patients with diabetes mellitus (DM) (59/126, 46.8%), solid organ malignancy (84/114, 73.7%), chronic kidney disease (CKD) (40/62, 64.5%) or receiving operation (109/147, 74.1%) were prone to develop candidiasis, while aspergillosis was usually complicated in patients with chronic obstructive pulmonary disease (COPD) (25/51, 49.0%). The all-cause mortality rate was 25.9% (135/521), and patients aged ≥80 years were the riskiest (20/51, 39.2%). Lymphopenia (59.5% vs 17.3%, P<0.001) was significant in deceased patients with mold infection. Higher proportion of non-survivors with invasive candidiasis received central venous catheterization (CVC) (68.4% vs 40.6%, P<0.001) or indwelling urinary catheter (68.4% vs 46.3%, P=0.001). Conclusion: IFD is a life-threatening complication especially in the oldest-old. Surveillance on lymphopenia, prompt treatment and reduce invasive procedures could benefit the prognosis.

<p>Clinical Features and Co-Infections in Invasive Pulmonary Aspergillosis in Elderly Patients</p>

“…In our previous study, we demonstrated that aspergillosis accounts for a growing proportion of invasive fungal diseases in the elderly population during the last two decades. 8 However, much is left to know due to the constraints of space. In the current study, we reported the clinical features of IPA in the elderly population, focusing on co-infections, aiming to provide an in-depth investigation of IPA in the specific population.…”

In vitro Activity of Isavuconazole and Comparators Against Clinical Isolates of Molds from a Multicenter Study in China

“…In addition to an increase in the incidence of IMIs globally and in China, 1–3 , 8 , 31 a gradual increase in patients with COVID-19 co-infected with IA or mucormycosis has also been reported. 32–36 The incidence of invasive pulmonary aspergillosis in patients with COVID-19 ranged from 19.4–33.3%.…”

Analysis of Clinical Characteristics and Diagnostic Value of Fungal Serology in Patients with Invasive Candidiasis

“…Our results indicated that elderly patients may be prone to invasive Candidiasis. It is previously reported that Candida is the most common type of fungus infection in elderly patients [12], with an incidence rate of 45.3%, which may be related to reduced immune function in the elderly [13]. In addition, 28 patients in the disease group gave details of their ward types, showing that patients were mainly concentrated in the emergency intensive care unit and the respiratory and critical care unit (75.00%, 21/28), which was consistent with the report [14].…”