The epidemiology of fungemia in an infectious diseases hospital in Mexico city: A 10-year retrospective review

Abstract

The epidemiology of invasive fungal infections has recently changed in immunosuppressed populations as a result of HIV infection, organ transplant, chemotherapy and in elderly patients. The diagnosis of invasive fungal infections by culture is prolonged since fungi grow slowly in vitro. we wanted to estimate the frequency of fungemia diagnoses established through the Clinical Mycology Laboratory over the past 10 years; through a retrospective study; data was obtained from the laboratory patient registry in the Infectious Disease Hospital's laboratory registry of patients with a systemic fungal isolate between 2005 and 2014. One hundred and thirty two (132) systemic fungal infections were identified. They were more prevalent in males, in the age group between 20 and 59 years and in patients with a diagnosis of AIDS. The most frequently isolated agents belonged to the genus Candida and others such as Histoplasma sp., Cryptococcus sp., Aspergillus sp., and Coccidioides sp. Of all blood and bone marrow cultures received 17.9% had fungal development; of these, in 70% of cases it was through blood cultures. In general, fungal agents were not diagnostically suspected. We identified that Sixty percent (60%) of fungemias developed in AIDS patients, followed by patients with sepsis. The most common agents belonged to the genus Candida, predominantly the albicans species. They were more frequently identified by blood culture than by bone marrow culture. Invasive fungal infections have not followed a usual clinical pattern and are not easily recognizable.

The status of cryptococcosis in Latin America

“…A national survey conducted in Argentina identified cryptococcosis as the second most frequent deep fungal infection with a prevalence of 20%, following that of yeast fungemia ( Davel and Canteros 2007 ). In Mexico, C. neoformans had a prevalence of 21% causing fungemia in patients with different types of immunosuppression, only following Histoplasma capsulatum ( Gaona-Flores et al 2016 ). In the same country, cryptococcosis was the third most common invasive fungal infection (13%) found in a highly specialised hospital, following candidiasis and mucormycosis ( Méndez-Tovar et al.…”

Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009–2015)

“…In our study, histoplasmosis, aspergillosis, and pneumocystosis showed an increasing trend in the number of cases, possibly due to the fact that during the time in which this study was conducted, new methods were implemented for the detection of antigens and molecular diagnostic assays, methods that are characterized for having higher sensitivity values compared with conventional methods [14,15,[26][27][28][29][30]33,34,36]. In most studies, reports of patients with invasive candidiasis have been reported to be more frequent than what we found in our study [4,5,[10][11][12]. This may be explained by the fact that our laboratory is not affiliated with a hospital, where the majority of cases of invasive candidiasis arise.…”

“…Therefore, the findings regarding the frequency of IFD cannot be applied to the adult Colombian population. It is also important to note that, when comparing this research with other reported studies, many of them based in the diagnosis of IFD using conventional diagnostic methods, which do not provide very high sensitivity values, such as the immunodiagnostic and molecular methods used in this investigation [4,5,[10][11][12].…”

“…The second study described 132 cases identified over a period of 10 years, also predominantly candidiasis, followed by histoplasmosis and cryptococcosis. Other IFD were identified less frequently including coccidioidomycosis and aspergillosis [12]. In Colombia, a cross-sectional, retrospective study in patients with systemic lupus reported 7.5% incidence of invasive fungal infections [13].…”

Inhibition of Candida albicans cell growth and biofilm formation by a bioactive extract produced by soil Streptomyces strain GCAL-25

“…The fluconazole-resistant C. albicans is the Candida yeast most frequently involved in diseases and is considered as a microorganism posing a serious hazard to humans, according to the Centers for Disease Control and Prevention (CDC) of the US Department of Health and Human Services [2]. A high incidence of candidiasis has been reported in hospitals, particularly in neonatal intensive care units, in HIV units and in organ transplant units [3][4][5].…”