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Invasive and Subcutaneous Infections Caused by Filamentous Fungi: Report from a Portuguese Multicentric Surveillance Program
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Orientador(es)
Resumo(s)
Invasive fungal infections (IFI) have significantly increased over the past years due to
advances in medical care for the at-risk immunocompromised population. IFI are often difficult to
diagnose and manage, and can be associated with substantial morbidity and mortality. This study
aims to contribute to understanding the etiology of invasive and subcutaneous fungal infections,
their associated risk factors, and to perceive the outcome of patients who developed invasive disease,
raising awareness of these infections at a local level but also in a global context. A laboratory
surveillance approach was conducted over a seven-year period and included: (i) cases of invasive
and subcutaneous fungal infections caused by filamentous/dimorphic fungi, confirmed by either
microscopy or positive culture from sterile samples, (ii) cases diagnosed as probable IFI according to
the criteria established by EORTC/MSG when duly substantiated. Fourteen Portuguese laboratories
were enrolled. Cases included in this study were classified according to the new consensus definitions
of invasive fungal diseases (IFD) published in 2020 as follows: proven IFI (N = 31), subcutaneous
fungal infection (N = 23). Those proven deep fungal infections (N = 54) totalized 71.1% of the total
cases, whereas 28.9% were classified as probable IFI (N = 22). It was possible to identify the etiological
fungal agent in 73 cases (96%). Aspergillus was the most frequent genera detected, but endemic
dimorphic fungi represented 14.47% (N = 11) of the total cases. Despite the small number of cases, a
high diversity of species were involved in deep fungal infections. This fact has implications for clinical
and laboratory diagnosis, and on the therapeutic management of these infections, since different
species, even within the same genus, can present diverse patterns of susceptibility to antifungals.
Descrição
This article belongs to the Special Issue Epidemiology and Diagnosis of Invasive Fungal Infections.
Palavras-chave
Invasive Fungal Infections Subcutaneous Fungal Infections Fungal Epidemiology surveillance Surveillance Portugal Infecções Sistémicas e Zoonoses
Contexto Educativo
Citação
Microorganisms. 2022 May 11;10(5):1010. doi: 10.3390/microorganisms10051010