CHANGING EPIDEMIOLOGY OF SYSTEMIC FUNGAL INFECTIONS AND THE POSSIBILITIES OF LABORATORY DIAGNOSTICS

Abstract

Advances in medical and surgical therapy over the past two decades have changed the nature of patient care during hospitalization. Recently developed technologies and therapies, involving bone marrow or solid-organ transplants and chemotherapeutic agents, have become common at many medical centers, resulting in the emergence of many immunocompromised individuals. In intensive care units (ICU) the use of invasive monitoring devices, parenteral nutrition, broad-spectrum antimicrobial agents, and assisted ventilation has helped in the treatment of patients suffering from previously devastating or fatal diseases and has provided opportunities for life to premature neonates previously thought to be non-viable [1]. However, these successes have resulted in the proliferation of a severely ill, immunocompromised, long-lasting hospitalized patient population. The AIDS epidemic has also added patients at risk to this growing population of immunocompromised individuals [2]. The immunocompromised patient is highly susceptible to nosocomial infections caused by organisms such as fungi that were previously considered to be of low virulence or „non-pathogenic” [3]. Besides the well-known endemic fungal pathogens (Histoplasma capsulatumCoccidioides immitisandBlastomyces dermatitidis), opportunisticCandidaspecies have been implicated most frequently in nosocomial fungal infections.