title: Epidemiology and identification of potential fungal pathogens causing invasive fungal infections in a tertiary care hospital in northeast Thailand.
abstract: Invasive fungal infections (IFIs) are life threatening and associated with a high mortality rate. Here, we describe the distribution of pathogens, host risk factors, and significance of fungi isolated from patients with IFIs. The study included 861 fungal isolates recovered between 2006 and 2011 from 802 patients at Srinagarind Hospital, Thailand. Based on 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 2008 criteria, 28.5% (245/861 isolates) of the fungal isolates were considered to be causative agents of IFIs. The most common fungus was Candida albicans (46%, 396/861 isolates). However, the most common yeast causing IFIs was Cryptococcus neoformans (34.7%, 85/245 isolates), while the most common mould was Penicillium marneffei (10.6%, 26/245 isolates). Cryptococcosis was significantly associated with human immunodeficiency virus infections (P < 0.001). Trend analysis revealed that there was no significant increase in IFI cases (P = 0.34) from 2006 to 2011 or from 2007 to 2011 (P = 0.05), but there was a trend toward significant increases in candidiasis (P = 0.04). The fungal isolates were categorized according to the positive predictive value of their recovery in cultures as being true (>95%), moderate (5%-95%), and rare (<5%) pathogens. This classification system could facilitate the prediction of the likelihood of diseases caused by the isolated fungi.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Khon Kaen University, Thailand Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Thailand kiatichai@kku.ac.th.
authors.forename: Kiatichai
authors.initials: K
authors.lastname: Faksri
authors.affiliation: Department of Microbiology, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: Wanlop
authors.initials: W
authors.lastname: Kaewkes
authors.affiliation: Department of Microbiology, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: Kunyaluk
authors.initials: K
authors.lastname: Chaicumpar
authors.affiliation: Clinical Microbiology Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: Prajuab
authors.initials: P
authors.lastname: Chaimanee
authors.affiliation: Department of Microbiology, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: Suwin
authors.initials: S
authors.lastname: Wongwajana
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000302:isolation & purification*; D009181:Mycoses / Q000453:epidemiology* / Q000382:microbiology*; D062606:Tertiary Care Centers; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
keywords: Thailand; invasive fungal infections; pathogen distribution; pathogenic potential; systemic mycoses