Rates of hospital acquired mold infections increasing

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Hospital acquired infections cause about 100,000 US deaths annually. While the majority of hospital acquired infections are due to bacteria and viruses, fungi (molds) are also important causes for life-threatening hospital acquired infections. The most common causes of mold related infections include Candida and Aspergillus.

Infections from Candida and Aspergillus cause approximately 100,000 invasive infections and about 20,000 deaths annually in the USA. Other fungi which commonly cause life-threatening hospital infections include Cryptococcus, Fusarum, Mucor, Rhizopus, Pneumocystis, Scedosporium and Penicillium marfenni.

Rates of invasive Candida and Aspergillus infection have been increasing during the last few decades. This has been due to a number of factors including : 1) increases in the numbers of HIV/ AIDS patients, 2) increases in patients with immune damaging cancers like leukemia and lymphoma, 3) increases in numbers of patients on immunosuppressive therapy for bone or organ transplants, or for auto-immune diseases and 4) increases in numbers of patients on long courses on antibiotics which can encourage growth of Candida and other molds.

Common sources of pathogenic molds in hospitals include the air (especially during hospital construction), water, surfaces in rooms and the hands of health care providers. Several studies have reported that better hospital hygiene (more handwashing and more thorough cleaning of surfaces) and use of HEPA air filters can significantly reduce hospital acquired fungal infections. Proper nutrition is also crucial in preventing and treating hospital acquired fungal infections. Several studies have reported that better hospital nutrition significantly reduces the risk of both fungal infections and death due to fungal infections. In some high risk patients, the use of prophylactic anti-fungal drugs- such as fluconazole, itraconazole, micafungin and caspofungin- can also significantly reduce risk of serious fungal hospital infections.

George Alangaden. Noscomial fungal infections: Epidemiology, infection control and prevention. Infectious Disease Clinics of North America 2011;25:210-25.

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