Epidemiology of Emerging Fungal Infections in ICU

Abstract

Purpose of Review: Globally, a change has been noticed in the epidemiology of fungal infections in the intensive care units (ICUs). The current review provides an insight into the current epidemiology of emerging fungal infections with special reference to their prevalence, spectrum of pathogen, outbreaks, and emergence of antifungal resistance reported from different ICUs of the world. Recent Findings: The ICUs across the world are witnessing multiple changes in the epidemiology of fungal infections including change in prevalence and spectrum of etiological agents, new susceptible risk groups, geographical variations, emergence of novel multi-drug resistant Candida auris, outbreak due to rare fungal species, emergence of antifungal resistance, etc. An understanding of the contemporary local epidemiology of fungal agents in ICU is essential for optimal patient management. Summary: Invasive candidiasis and invasive aspergillosis continue to haunt as major pathogens in the ICU, and several new risk factors associated with these infections have surfaced up. There is a contrasting picture for the species distribution of Candida among the different countries of the world. C. auris, the yeast behaving like bacteria, has emerged as a potential threat to ICUs across the five continents. Other mycelial agents like Mucorales, Paecilomyces spp., Fusarium spp., and Cladosporium spp., although encountered infrequently, continue to be reported as serious infections in ICU. The ICUs are also vulnerable sites for fungal infection outbreaks due to several fungi including rare ones like Cryptococcus spp., Pichia anomala, and Kodamaea ohmeri.