Fungi

Author(s):
DJ Shannon, MPH, CIC, VA-BC, FAPIC Infection Preventionist

Indiana University Health Adult Academic Health Center

 

Adjunct Faculty

Department of Epidemiology

Richard M. Fairbanks School of Public Health

Indiana University Indianapolis

Published:

Original Publication:
May 14, 2024
Declarations of Conflicts of Interest:
  • DJ Shannon previously received honoraria toward his work with ICU Medical, and is the 2024 President of APIC Indiana. He is also a paid consultant of Teleflex Inc. DJ Shannon declares no other conflicts of interest.

Abstract

The face of healthcare-associated fungal infections is changing. Candida spp. continue to play a significant role in these infections, and substantial morbidity and mortality are associated with candidiasis. Additionally, the incidence of infections involving opportunistic molds and other unusual fungal pathogens is increasing. This chapter reviews the epidemiology, clinical manifestations, laboratory detection, treatment, and prevention of fungal infections. Prevention measures include hand hygiene, Standard and Contact Precautions, antimicrobial stewardship, water system management, air filtration, and construction management.

Identification of fungal pathogens in the laboratory has also undergone a major shift. New antigen and antibody tests as well as rapid diagnostic polymerase chain reaction tests are increasingly used.

Treatment of fungal infections remains a challenge as options are limited to three primary drug classes: azoles, echinocandins, and polyenes, and the medications may have adverse effects. Furthermore, antifungal resistance is an increasing concern.