Fungal neuroinfections and fungaemia: unexpected increase of mortality from invasive fungal infections in 2005-2011 in comparison to 1989-1998: analysis of 210 cases.

Demitrovicova A, Liskova A, Valach M, Izakovic M, Noge A, Baranova J, Kalatova D, Syrovatkova L, Velicova J, Bugykova B, Gulasova I, Seinova D, Mikolasova G, Mutalova M, Pilkova M, Szabo I, Findova L, Madarasz I, Stanzyk M, Mikulickova D, Blazekova M, Jankechova M, Slezakova Z, Kuriplachova G, Visnovsky J, Obrocnikova A, Blumm M, Blumm B, Wolfram S, Zeleny P, Otrubova J, Rudinsky B, Nagyova Z, Vravcova M, Kajaba J, Jexova S, Oravec S, Toth S, Klobucka S, Gerigh J, Schumann F, Ambra R, Bandura P, Bonnack C, Kubisova Z, Palo M, Kalavsky E, Drgona L, Mahesvaari R, Riedl J.
  Vol. 34 (Suppl 1) 2013 Neuro endocrinology letters Journal Article   2013; 34(Suppl 1): 32-35 PubMed PMID:  24013604    Citation

OBJECTIVE: In this short communication we compared the data of fungaemia cases in Slovak hospitals from 1989-1998 published in 1999-2000 with data from 2005-2011.

METHODS: Risk factors, etiology and outcome of fungaemia between two periods (1989-1998 vs. 2005-2011) were compared and risk factors for death assessed by univariate analysis (CDC 2006 Statistical Package).

RESULTS: In comparison to 1989-1998 when only amphotericin B and fluconazole has been used (55%), in 2005-2011 only 35.2% patients received FLU, but 26.4% received voriconazole, 22% caspofungin and anidulafungin and about 6.6% lipid formulations of Amphotericin B. In etiology, while in 1989-1998 only 37.1% (115/310) represented non-albicans Candida (NAC) and non-Candida yeasts in 2005-2011 already reached 63.7%. The significant increase of breakthrough fungaemia may be a sign of inappropriate empiric therapy.