Emerging and reemerging microbial threats. Nosocomial fungal infections
V. J. Henderson and E. R. Hirvela
Department of Surgery, University of California, Davis-East Bay, Oakland, USA.
The incidence of nosocomial fungal infections had been increasing steadily
for the past 25 years. Although they were once believed to be of little
clinical consequence, there is now compelling evidence that fungal agents
represent a bona fide microbial threat with substantial morbidity and high
mortality. Reporting on a series of 30447 nosocomial fungal infections that
occurred in the decade from 1980 to 1990, Beck-Sague and Jarvis noted
increases in incidence from 90% to 175%. Infection rates rose from 2.0 per
1000 discharges to as high as 6.6 infections per 1000 discharges. Fungal
infections increased at all major anatomic sites, including surgical
wounds, lung, urinary tract, and bloodstream. Candida species accounted for
78.3% of nosocomial fungal infections, while torulopsis species and
aspergillus species accounted for 7.3% and 1.3%, respectively.
