Trends in the prevalence of invasive fungal infections from an analysis of annual records of autopsy cases of Toho University

Abstract

Clinical diagnosis of invasive fungal infections (IFIs) is sometimes difficult, and obtaining an accurate assessment of trends concerning the prevalence of IFIs is a challenge. The aim of this study was to determine trends in the prevalence of IFIs from an autopsy survey. The retrospective review of autopsy records stored in Toho University was performed on all documented cases with fungal infection from 1955 to 2006. A total of 411 cases of IFIs were detected among 10 297 autopsies. The prevalence of candidiasis decreased from 3.6% (1981-93) to 2.0% (1994-2006), and that of aspergillosis increased throughout the 52-year period and reached 2.0% (1994-2006). The prevalence of IFIs in the patient group comprising haematological disorders was significantly higher (19.9%) than in other patient groups (2.9%), of which the odds ratio was 18.4 for mucormycosis and 10.0 for aspergillosis. The lung was the most common organ involved irrespective of major fungal species, and most cases with candidiasis showed multiple-organ infection. Results confirmed the increasing prevalence of aspergillosis and high risk of IFIs in the patient group with haematological disorders. IFIs were also detected in an immunocompromised state caused not only by primary disease but also by treatment with anti-tumour drugs and corticosteroids.

Antifungal Susceptibility of Aspergillus Species Isolated from Patients Diagnosed with Invasive Aspergillosis

“…İnvazif küf infeksiyonlarının en sık nedeni Aspergillus cinsinde yer alan mantarlardır (22) . Bunlar invazif infeksiyonlardan alerjik sendromlara kadar değişen klinik tablolara neden olmaktadır (11,12) .…”

Comparison between the Effectiveness of Polymerase Chain Reaction and In Situ Hybridization in Detecting the Presence of Pathogenic Fungi by Using the Preserved DNA in Formalin-Fixed and Paraffin-Embedded Tissues

“…The presence of fungal infections was confirmed through histopathological analysis of all samples by 3 expert pathologists who reexamined the samples using hematoxylin and eosin staining and Grocott's methenamine silver (GMS) staining. Since it has been previously reported that the lung was the most common organ involved irrespective of major fungal species, the lung was adopted as the representative organ of IFI (7). Tissues obtained from the autopsies were fixed in 15z unbuffered formalin before being paraffin embedded and stored at room temperature.…”

The Management of Invasive Fungal Infections: What to Consider in Empirical Treatment?

“…The prevalence of candidiasis decreased from 3.6% (1981-93) to 2.0% (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006), while that of aspergillosis increased throughout the 52-year period and reached 2.0%. 3 Additionally, similar to the development of antibiotic resistance, the use of broad-spectrum antifungal agents such as voriconazole has led to the emergence of IFI caused by the mucormycetes class of fungi. 4 In a case-control study involving 14 leukemic and 13 HSCT patients, voriconazole prophylaxis was identified as an independent risk factor, increasing the risk for invasive mucormycosis by more than 10-fold.…”