Abstract
The term invasive fungal disease (IFD) incorporates severe systemic or deep-seated infections due to fungi. A rise in the prevalence of IFD has been observed in recent years, primarily due to the rising numbers of susceptible host population, increasing invasive therapeutic interventions and immunosuppressive treatments. In addition, the expanding spectrum of fungal pathogenicity, rise in infection due to previously obscure fungi, and development of fungal thermal adaptation are also main concerns. Challenge also lies in diagnostics due to the absence of validated, prompt, and accurate diagnostic test for IFD and also differentiating infection from mere colonization. Factors related to antifungal treatment, such as point of initiation, duration of treatment, lack of ideal drug with good pharmacokinetics and pharmacodynamics, drug toxicity, and difficulty in accessing antifungal drugs affect the patient outcome. The rise in antifungal resistance, which stems from incoherent antifungal use in clinical practice and the agriculture industry, is also a matter of concern. Although IFD continues to threaten humans worldwide, our understanding of the factors affecting its changing epidemiology is still not clear. Educating clinicians and laboratory personnel about the complex issues regarding IFD diagnosis and management is essential.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Andes D, Pascual A, Marchetti O (2009) Antifungal therapeutic drug monitoring: established and emerging indications. Antimicrob Agents Chemother 53:24–34. https://doi.org/10.1128/AAC.00705-08
Arendrup MC et al (2011) National surveillance of fungemia in Denmark (2004–2009). J Clin Microbiol 49:325–334. https://doi.org/10.1128/JCM.01811-10
Ascioglu S et al (2002) Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 34:7–14. https://doi.org/10.1086/323335
Bagshaw E et al (2018) Economic impact of treating invasive mold disease with isavuconazole compared with liposomal amphotericin B in the UK. Future Microbiol 13:1283–1293. https://doi.org/10.2217/fmb-2018-0119
Bajwa S, Kulshrestha A (2013) Fungal infections in intensive care unit: challenges in diagnosis and management. Ann Med Health Sci Res 3:238–244. https://doi.org/10.4103/2141-9248.113669
Banerjee R et al (2015) Randomized trial of rapid multiplex polymerase chain reaction–based blood culture identification and susceptibility testing. Clin Infect Dis 61:1071–1080. https://doi.org/10.1093/cid/civ447
Bansal N et al (2018) Experience with β-D-glucan assay in the management of critically ill patients with high risk of invasive candidiasis: an observational study. Indian J Crit Care Med 22:364–368. https://doi.org/10.4103/ijccm.IJCCM_4_18
Barros MBL et al (2008) An epidemic of sporotrichosis in Rio de Janeiro, Brazil: epidemiological aspects of a series of cases. Epidemiol Infect 136:1192–1196. https://doi.org/10.1017/S0950268807009727
Bastos de Lima Barros M et al (2004) Cat-transmitted sporotrichosis epidemic in Rio de Janeiro, Brazil: description of a series of cases. Clin Infect Dis 38:529–535. https://doi.org/10.1086/381200
Benedict K, Park BJ (2014) Invasive fungal infections after natural disasters. Emerg Infect Dis 20:349–355. https://doi.org/10.3201/eid2003.131230
Berger S et al (2017) Azole resistance in aspergillus fumigatus: a consequence of antifungal use in agriculture? Front Microbiol 8:1024. https://doi.org/10.3389/fmicb.2017.01024
Blot SI et al (2012) A clinical algorithm to diagnose invasive pulmonary aspergillosis in critically ill patients. Am J Respir Crit Care Med 186:56–64. https://doi.org/10.1164/rccm.201111-1978OC
Bongomin F et al (2017) Global and multi-national prevalence of fungal diseases—estimate precision. J Fungi 3:57. https://doi.org/10.3390/jof3040057
Boonsarngsuk V et al (2010) False-positive serum and bronchoalveolar lavage Aspergillus galactomannan assays caused by different antibiotics. Scand J Infect Dis 42:461–468. https://doi.org/10.3109/00365541003602064
Buchan BW, Ledeboer NA (2013) Advances in identification of clinical yeast isolates by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 51:1359–1366. https://doi.org/10.1128/JCM.03105-12
Bulpa PA et al (2001) Chronic obstructive pulmonary disease patients with invasive pulmonary aspergillosis: benefits of intensive care? Intensive Care Med 27:59–67. Available at: http://www.ncbi.nlm.nih.gov/pubmed/11280674. Accessed 14 Jan 2019
Casadevall A (2012) Fungi and the rise of mammals. PLoS Pathog 8:e1002808. https://doi.org/10.1371/journal.ppat.1002808
Chakrabarti A (2011) Drug resistance in fungi-an emerging problem. Available at: http://www.searo.who.int/publications/journals/regional_health_forum/media/2011/V15n1/rhfv15n1p97.pdf. Accessed 8 Jan 2019
Chakrabarti A et al (1996) Antifungal susceptibility pattern of non-albicans Candida species distribution of species isolated from candidaemia cases over a 5 year period. Indian J Med Res 104:171–176. Available at: http://www.ncbi.nlm.nih.gov/pubmed/8840655. Accessed 14 Jan 2019
Chakrabarti A et al (2001) Outbreak of Pichia anomala infection in the pediatric service of a tertiary-care center in northern India. J Clin Microbiol 39:1702–1706. https://doi.org/10.1128/JCM.39.5.1702-1706.2001
Chakrabarti A et al (2014) Epidemiological study of a large cluster of fungaemia cases due to Kodamaea ohmeri in an Indian tertiary care centre. Clin Microbiol Infect 20:O83–O89. https://doi.org/10.1111/1469-0691.12337
Chakrabarti A et al (2015) Incidence, characteristics and outcome of ICU-acquired candidemia in India. Intensive Care Med 41:285–295. https://doi.org/10.1007/s00134-014-3603-2
Chapman B et al (2016) Changing epidemiology of candidaemia in Australia. J Antimicrob Chemother 72:422. https://doi.org/10.1093/jac/dkw422
Chow JK et al (2008) Factors associated with candidemia caused by non- albicans candida species versus candida albicans in the intensive care unit. Clin Infect Dis 46:1206–1213. https://doi.org/10.1086/529435
Clancy CJ, Nguyen MH (2013) Finding the mMissing 50% of invasive candidiasis: how nonculture diagnostics will improve understanding of disease spectrum and transform patient care. Clin Infect Dis 56:1284–1292. https://doi.org/10.1093/cid/cit006
Cleveland AA et al (2015) Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008–2013: results from population-based surveillance. PLoS One 10:e0120452. https://doi.org/10.1371/journal.pone.0120452
Cooney NM, Klein BS (2008) Fungal adaptation to the mammalian host: it is a new world, after all. Curr Opin Microbiol 11:511–516. https://doi.org/10.1016/j.mib.2008.09.018
De Pascale G, Antonelli M (2014) Candida colonization of respiratory tract: to treat or not to treat, will we ever get an answer? Intensive Care Med 40:1381–1384. https://doi.org/10.1007/s00134-014-3364-y
De Pauw B et al (2008) Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46:1813–1821. https://doi.org/10.1086/588660
Denning DW et al (2017) Delivering on antimicrobial resistance agenda not possible without improving fungal diagnostic capabilities. Emerg Infect Dis 23:177–183. https://doi.org/10.3201/eid2302.152042
Firacative C et al (2018) The status of cryptococcosis in Latin America. Mem Inst Oswaldo Cruz 113:1–23. https://doi.org/10.1590/0074-02760170554
Garcia-Solache MA, Casadevall A (2010) Global warming will bring new fungal diseases for mammals. MBio 1:e00061-10. https://doi.org/10.1128/mBio.00061-10
Gedik H (2015) The expenditures related to the use of antifungal drugs in patients with hematological cancers: a cost analysis. Clinico-Econ Outcomes Res 7:537–543. https://doi.org/10.2147/CEOR.S92455
Guinea J et al (2017) Increasing incidence of mucormycosis in a large Spanish hospital from 2007 to 2015: epidemiology and microbiological characterization of the isolates. PLoS One 12(6):e0179136. https://doi.org/10.1371/journal.pone.0179136
Hamdy RF, Zaoutis TE, Seo SK (2017) Antifungal stewardship considerations for adults and pediatrics. Virulence 8:658–672. https://doi.org/10.1080/21505594.2016.1226721
Hayden RT et al (2002) In situ hybridization for the identification of filamentous fungi in tissue section. Diagn Mol Pathol 11:119–126. Available at: http://www.ncbi.nlm.nih.gov/pubmed/12045716. Accessed 14 Jan 2019
Herbrecht R et al (2010) Comparative survival and cost of antifungal therapy: posaconazole versus standard antifungals in the treatment of refractory invasive aspergillosis. Curr Med Res Opin 26:2457–2464. https://doi.org/10.1185/03007995.2010.516110
Hesstvedt L et al (2015) Twenty-two years of candidaemia surveillance: results from a Norwegian national study. Clin Microbiol Infect 21:938–945. https://doi.org/10.1016/j.cmi.2015.06.008
Horn DL et al (2009) Epidemiology and outcomes of candidemia in 2019 patients: data from the prospective antifungal therapy alliance registry. Clin Infect Dis 48:1695–1703. https://doi.org/10.1086/599039
Huang AM et al (2013) Impact of rapid organism identification via matrix-assisted laser desorption/ionization time-of-flight combined with antimicrobial stewardship team intervention in adult patients with bacteremia and candidemia. Clin Infect Dis 57:1237–1245. https://doi.org/10.1093/cid/cit498
Idelevich EA, Grünastel B, Becker K (2017) Rapid detection and identification of candidemia by direct blood culturing on solid medium by use of lysis-centrifugation method combined with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). J Clin Microbiol 55:97–100. https://doi.org/10.1128/JCM.01787-16
Jeffery-Smith A et al (2018) Candida auris: a review of the literature. Clin Microbiol Rev 31:e00029–e00017. https://doi.org/10.1128/CMR.00029-17
Jeong W et al (2019) The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clin Microbiol Infect 25:26–34. https://doi.org/10.1016/j.cmi.2018.07.011
Kitaura T et al (2018) Cryptococcus gattii genotype VGIIa infection imported from Vancouver Island to Japan. J Infect Chemother 24:573–575. https://doi.org/10.1016/j.jiac.2017.12.014
Kneale M et al (2016) Global access to antifungal therapy and its variable cost. J Antimicrob Chemother 71:3599–3606. https://doi.org/10.1093/jac/dkw325
Ko BS et al (2018) 2016 guideline strategies for the use of antifungal agents in patients with hematological malignancies or hematopoietic stem cell transplantation recipients in Taiwan. J Microbiol 51(3):287–301. https://doi.org/10.1016/j.jmii.2017.07.005
Krasinski K et al (1985) Nosocomial fungal infection during hospital renovation. Infect Control 6:278–282. Available at: http://www.ncbi.nlm.nih.gov/pubmed/3847404. Accessed 14 Jan 2019
Kyvernitakis A et al (2016) Initial use of combination treatment does not impact survival of 106 patients with haematologic malignancies and mucormycosis: a propensity score analysis. Clin Microbiol Infect 22:811.e1–811.e8. https://doi.org/10.1016/j.cmi.2016.03.029
Lamoth F et al (2018) Changes in the epidemiological landscape of invasive candidiasis. J Antimicrob Chemother 73:i4–i13. https://doi.org/10.1093/jac/dkx444
Lanternier F et al (2012) Mucormycosis in organ and stem cell transplant recipients. Clin Infect Dis 54:1–8. https://doi.org/10.1093/cid/cis195
Lempers VJ et al (2015) Drug-interactions of azole antifungals with selected immunosuppressants in transplant patients: strategies for optimal management in clinical practice. Curr Opin Pharmacol 24:38–44. https://doi.org/10.1016/j.coph.2015.07.002
Lockhart SR et al (2017) Simultaneous emergence of multidrug-resistant candida auris on 3 continents confirmed by whole-genome sequencing and epidemiological analyses. Clin Infect Dis 64:134–140. https://doi.org/10.1093/cid/ciw691
Morrell M, Fraser VJ, Kollef MH (2005) Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agents Chemother 49:3640–3645. https://doi.org/10.1128/AAC.49.9.3640-3645.2005
Nivoix Y et al (2008) Factors associated with overall and attributable mortality in invasive aspergillosis. Clin Infect Dis 47:1176–1184. https://doi.org/10.1086/592255
Perfect JR et al (2010) Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 50:291–322. https://doi.org/10.1086/649858
Perlroth J, Choi B, Spellberg B (2007) Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Med Mycol 45:321–346. https://doi.org/10.1080/13693780701218689
Ribas E, Ribas AD et al (2016) Is the emergence of fungal resistance to medical triazoles related to their use in the agroecosystems? A mini review. Braz J Microbiol 47:793–799. https://doi.org/10.1016/j.bjm.2016.06.006
Richardson MD (2016) An introduction to antifungal stewardship. J Antimicrob Chemother 71:ii3–ii3. https://doi.org/10.1093/jac/dkw390
Rickerts V et al (2012) Enhanced fungal DNA-extraction from formalin-fixed, paraffin-embedded tissue specimens by application of thermal energy. Med Mycol 50:667–672. https://doi.org/10.3109/13693786.2012.665613
Rivero-Menendez O et al (2016) Triazole resistance in Aspergillus spp.: a worldwide problem? J Fungi 2(3):21. https://doi.org/10.3390/jof2030021
Robert VA, Casadevall A (2009) Vertebrate endothermy restricts most fungi as potential pathogens. J Infect Dis 200:1623–1626. https://doi.org/10.1086/644642
Robert V, Cardinali G, Casadevall A (2015) Distribution and impact of yeast thermal tolerance permissive for mammalian infection. BMC Biol 13:18. https://doi.org/10.1186/s12915-015-0127-3
Roe CC et al (2018) Dating the Cryptococcus gattii dispersal to the North American Pacific Northwest. mSphere 3:pii: e00499-17. https://doi.org/10.1128/mSphere.00499-17
Spellberg B, Ibrahim AS (2010) Recent advances in the treatment of mucormycosis. Curr Infect Dis Rep 12:423–429. https://doi.org/10.1007/s11908-010-0129-9
Spellberg B et al (2012) Risk factors for mortality in patients with mucormycosis. Med Mycol 50:611–618. https://doi.org/10.3109/13693786.2012.669502
Suh MK et al (2012) Molecular phylogenetics of exophiala species isolated from Korea. Ann Dermatol 24:287–294. https://doi.org/10.5021/ad.2012.24.3.287
Vallabhaneni S et al (2015) Epidemiology and risk factors for echinocandin nonsusceptible candida glabrata bloodstream infections: data from a large multisite population-based candidemia surveillance program, 2008–2014. Open Forum Infect Dis 2:ofv163. https://doi.org/10.1093/ofid/ofv163
Vazquez L (2016) Antifungal prophylaxis in immunocompromised patients. Mediterranean J Hematol Infect Dis 8:e2016040. https://doi.org/10.4084/MJHID.2016.040
Vella A et al (2017) Potential use of MALDI-ToF mass spectrometry for rapid detection of antifungal resistance in the human pathogen candida glabrata. Sci Rep 7(1):9099. https://doi.org/10.1038/s41598-017-09329-4
Verma N et al (2018) Invasive fungal infections amongst patients with acute-on-chronic liver failure at high risk for fungal infections. Liver Int 1:11. https://doi.org/10.1111/liv.13981
Vincent JL et al (2009) International study of the prevalence and outcomes of infection in intensive care units. JAMA 302:2323. https://doi.org/10.1001/jama.2009.1754
Wang Y et al (2017) Choosing optimal antifungal agents to prevent fungal infections in nonneutropenic critically ill patients: trial sequential analysis, network meta-analysis, and pharmacoeconomic analysis. Antimicrob Agents Chemother 61:piie00620-17. https://doi.org/10.1128/AAC.00620-17
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Chakrabarti, A., Singh, S. (2019). Challenges in Invasive Fungal Disease. In: Satyanarayana, T., Deshmukh, S., Deshpande, M. (eds) Advancing Frontiers in Mycology & Mycotechnology. Springer, Singapore. https://doi.org/10.1007/978-981-13-9349-5_18
Download citation
DOI: https://doi.org/10.1007/978-981-13-9349-5_18
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-9348-8
Online ISBN: 978-981-13-9349-5
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)