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Epidemiology of Invasive Fungal Infections in Patients with Acquired Immunodeficiency Syndrome at a Reference Hospital for Infectious Diseases in Brazil

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Abstract

Invasive fungal infections (IFIs) represent one of the main causes of morbimortality in immunocompromised patients. Pneumocystosis, cryptococcosis and histoplasmosis are the most frequently occurring IFIs in patients with acquired immunodeficiency syndrome (AIDS). Fungi, such as Candida spp. and Aspergillus spp., may cause severe diseases during the course of an HIV infection. Following the introduction of highly active anti-retroviral therapy, there has been a marked reduction of opportunistic fungal infections, which today is 20–25 % of the number of infections observed in the mid-1990s. This study is an observational and retrospective study aimed at the characterising IFI incidence and describing the epidemiology, clinical diagnostic and therapeutic features and denouement in HIV/AIDS patients. In HIV/AIDS patients, the IFI incidence is 54.3/1,000 hospitalisation/year, with a lethality of 37.7 %. Cryptococcosis represents the main opportunistic IFI in the population, followed by histoplasmosis. Nosocomial pathogenic yeast infections are caused principally by Candida spp., with a higher candidemia incidence at our institution compared to other Brazilian centres.

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References

  1. McNeil MM, Nash SL, Hajjeh RA, Phelan MA, Conn LA, Plikaytis BD, et al. Trends in mortality due to invasive mycotic diseases in the United States, 1980–1997. Clin Infect Dis. 2001;33(5):641–7.

    Article  CAS  PubMed  Google Scholar 

  2. Pfaller MA, Diekema DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol. 2010;36(1):1–53.

    Article  PubMed  Google Scholar 

  3. Pursell KJ, Telzak EE, Armstrong D. Aspergillus species colonization and invasive disease in patients with AIDS. Clin Infect Dis. 1992;14(1):141–8.

    Article  CAS  PubMed  Google Scholar 

  4. Burckhardt B, Sendi P, Pfluger D, Zimmerli W, Nüesch R, Bucher HC, et al. Rare AIDS-defining diseases in the Swiss HIV Cohort Study. Eur J Clin Microbiol Infect Dis. 1999;18(6):399–402.

    Article  CAS  PubMed  Google Scholar 

  5. Haddad NE, Powderly WG. The changing face of mycoses in patients with HIV/AIDS. AIDS Read. 2001:11(7):365–368, 375–378.

  6. Castro KG, Ward JW, Slutsker L, Buehler JW, Jaffe HW, Berkelman RL, Curran JW. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep. 1992;41(RR-17):1–19.

    Google Scholar 

  7. Kaplan JE, Hanson D, Dworkin MS, Frederick T, Bertolli J, Lindegren MI, et al. Epidemiology of human immunodeficiency virus-associated opportunistic infections in the United Stated in the era of highly active antiretroviral therapy. Clin Infect Dis. 2000;30(Suppl 1):S5–14.

    Article  PubMed  Google Scholar 

  8. Antinori S, Nebuloni M, Magni C, Fasan M, Adorni F, Viola A, et al. Trends in the postmortem diagnosis of opportunistic invasive fungal infections in patients with AIDS: a retrospective study of 1,630 autopsies performed between 1984 and 2002. Am J Clin Pathol. 2009;132(2):221–7.

    Article  PubMed  Google Scholar 

  9. Prado M, Silva MB, Laurenti R, Travassos L, Taborda CP. Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: a review from 1996 to 2006. Mem Inst Oswaldo Cruz. 2009;104(3):513–21.

    Article  PubMed  Google Scholar 

  10. Antinori S, Ridolfo AL, Fasan M, Magni C, Galimberti L, Milazzo L, et al. AIDS-associated cryptococcosis: a comparison of epidemiology, clinical features and outcome in the pre- and post-HAART eras. Experience of a single centre in Italy. HIV Med. 2009;10(1):6–11.

    Article  CAS  PubMed  Google Scholar 

  11. Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM. Estimation of the global burden of cryptococcal meningitis among persons living with HIV (AIDS). AIDS. 2009;23:525–30.

    Article  PubMed  Google Scholar 

  12. Vidal JE, Gerhardt J, de Miranda EJP, Dauar RF, Oliveira Filho GS, de Oliveira ACP, Boulwaref DR. Role of quantitative CSF microscopy to predict culture status and outcome in HIV-associated cryptococcal meningitis in a Brazilian cohort. Diagn Microbiol Infect Dis. 2012;73:68–73.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Vidal JE, de Oliveira ACP, Dauar RF, Boulwared DR. Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America. Braz J Infect Dis. 2013;17(3):353–62.

    Article  PubMed Central  PubMed  Google Scholar 

  14. McKinsey D. Histoplasmosis in AIDS: advances in management. AIDS Patient Care STDS. 1998;12(10):775–81.

    Article  CAS  PubMed  Google Scholar 

  15. Daher EF, Silva GB Jr, Barros FAS, Takeda CFV, Mota RMS, Ferreira MT, et al. Clinical and laboratory features of disseminated histoplasmosis in HIV patients from Brazil. Trop Med Int Health. 2007;12(9):1108–15.

    Article  PubMed  Google Scholar 

  16. Mansilla M, Da Silveira AD, Laca HN, Balleste R, Braselli A. Clinical manifestation of aids-associated histoplasmosis in Uruguay. In: 12th International conference on AIDS. June 28–July 3 Geneva. 1998. p. 307.

  17. Benard G, Duarte AJS. Paracoccidioidomycosis: a model for evaluation of the effects of human immunodeficiency virus infection on the natural history of endemic tropical diseases. Clin Infect Dis. 2000;31(4):1032–9.

    Article  CAS  PubMed  Google Scholar 

  18. Sanchez MR, Ponge-Wilson I, Moy JA, Rosenthal S. Zygomycosis and HIV infection. J Am Acad Dermatol. 1994;30:904–8.

    Article  CAS  PubMed  Google Scholar 

  19. Corbel MJ, Eades SM. Factors determining the susceptibility of mice to experimental phycomycosis. J Med Microbiol. 1975;8(4):551–64.

    Article  CAS  PubMed  Google Scholar 

  20. Kontoyiannis DP, Torres HA, Chagua M, Hachem R, Tarrand JJ, Bodey GP, et al. Trichosporonosis in a tertiary care cancer center: risk factors, changing spectrum and determinants of outcome. Scand J Infect Dis. 2004;36(8):564–9.

    Article  PubMed  Google Scholar 

  21. Gross JW, Kan VL. Trichosporon asahii infection in an advanced AIDS patient and literature review. AIDS. 2008;22(6):793–5.

    Article  PubMed  Google Scholar 

  22. Munoz P, Bouza E, Cuenca-Estrella M, Eiros JM, Perez MJ, Sanchez-Somolinos M, et al. Saccharomyces cerevisiae fungemia: an emerging infectious disease. Clin Infect Dis. 2005;40(11):1625–34.

    Article  PubMed  Google Scholar 

  23. Nucci M, Queiroz-Telles F, Alvarado-Matute T, Tiraboschi IN, Cortes J, Zurita J, Guzman-Blanco M, et al. Epidemiology of candidemia in Latin America: a laboratory-based survey. PLoS ONE. 2013;8(3):e59373. doi:10.1371/journal.pone.0059373.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This study was supported, in part, by the Centro de Estudos Emílio Ribas, São Paulo, Brasil.

Conflict of interest

None of the authors have any potential conflict of interest or financial support in the subject matter.

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Author notes

  1. Daniel Wagner de Castro Lima Santos

    Present address: Commission of Hospital Infection Control, Institute of Infectious Diseases Emílio Ribas, Avenida Doutor Arnaldo, 165, Cerqueira César, São Paulo, SP, Brazil

Authors and Affiliations

  1. Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil

    Renata Buccheri de Oliveira, Jane Harumi Atobe, Simone Aparecida Souza & Daniel Wagner de Castro Lima Santos

  2. Laboratório Especial de Micologia - LEMI, Departamento de Infectologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Daniel Wagner de Castro Lima Santos

Authors
  1. Renata Buccheri de Oliveira
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  2. Jane Harumi Atobe
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  3. Simone Aparecida Souza
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  4. Daniel Wagner de Castro Lima Santos
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Corresponding author

Correspondence to Daniel Wagner de Castro Lima Santos.

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de Oliveira, R.B., Atobe, J.H., Souza, S.A. et al. Epidemiology of Invasive Fungal Infections in Patients with Acquired Immunodeficiency Syndrome at a Reference Hospital for Infectious Diseases in Brazil. Mycopathologia 178, 71–78 (2014). https://doi.org/10.1007/s11046-014-9755-3

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  • DOI: https://doi.org/10.1007/s11046-014-9755-3

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