CouldHistoplasma capsulatumBe Related to Healthcare-Associated Infections?

Abstract

Healthcare-associated infections (HAI) are described in diverse settings. The main etiologic agents of HAI are bacteria (85%) and fungi (13%). Some factors increase the risk for HAI, particularly the use of medical devices; patients with severe cuts, wounds, and burns; stays in the intensive care unit, surgery, and hospital reconstruction works. Several fungal HAI are caused byCandidaspp., usually from an endogenous source; however, cross-transmission via the hands of healthcare workers or contaminated devices can occur. Although other medically important fungi, such asBlastomyces dermatitidis,Paracoccidioides brasiliensis, andHistoplasma capsulatum, have never been considered nosocomial pathogens, there are some factors that point out the pros and cons for this possibility. Among these fungi,H. capsulatuminfection has been linked to different medical devices and surgery implants. The filamentous form ofH. capsulatummay be present in hospital settings, as this fungus adapts to different types of climates and has great dispersion ability. Although conventional pathogen identification techniques have never identifiedH. capsulatumin the hospital environment, molecular biology procedures could be useful in this setting. More research onH. capsulatumas a HAI etiologic agent is needed, since it causes a severe and often fatal disease in immunocompromised patients.