Trends in the prevalence of invasive fungal infections from an analysis of annual records of autopsy cases of Toho University.
Clinical diagnosis of invasive fungal infections (IFIs) is sometimes difficult, and obtaining an accurate assessment of trends concerning the prevalence of IFIs is a challenge. The aim of this study was to determine trends in the prevalence of IFIs from an autopsy survey. The retrospective review of autopsy records stored in Toho University was performed on all documented cases with fungal infection from 1955 to 2006. A total of 411 cases of IFIs were detected among 10 297 autopsies. The prevalence of candidiasis decreased from 3.6% (1981-93) to 2.0% (1994-2006), and that of aspergillosis increased throughout the 52-year period and reached 2.0% (1994-2006). The prevalence of IFIs in the patient group comprising haematological disorders was significantly higher (19.9%) than in other patient groups (2.9%), of which the odds ratio was 18.4 for mucormycosis and 10.0 for aspergillosis. The lung was the most common organ involved irrespective of major fungal species, and most cases with candidiasis showed multiple-organ infection. Results confirmed the increasing prevalence of aspergillosis and high risk of IFIs in the patient group with haematological disorders. IFIs were also detected in an immunocompromised state caused not only by primary disease but also by treatment with anti-tumour drugs and corticosteroids.
Department of Surgical Pathology, Toho University School of Medicine, Tokyo, Japan.
Kayoko
K
Shimodaira
Yoichiro
Y
Okubo
Haruo
H
Nakayama
Megumi
M
Wakayama
Minoru
M
Shinozaki
Takao
T
Ishiwatari
Daisuke
D
Sasai
Tetsuo
T
Nemoto
Kei
K
Takahashi
Toshiharu
T
Ishii
Tsutomu
T
Saji
Kazutoshi
K
Shibuya
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D014495:Universities; D055815:Young Adult