Prevalence and Healthcare Burden of Fungal Infections in the United States, 2018

Abstract

Background Fungal infections are responsible for >1.5 million deaths globally per year, primarily in those with compromised immune function. This is concerning as the number of immunocompromised patients, especially in those without human immunodeficiency virus (HIV), has risen in the past decade. The purpose of this analysis was to provide the current prevalence and impact of fungal disease in the United States. Methods We analyzed hospital discharge data from the most recent (2018) Healthcare Cost and Utilization Project National Inpatient Sample, and outpatient visit data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Costs are presented in 2018 United States (US) dollars. Results In the 35.5 million inpatient visits documented in 2018 in the US, approximately 666 235 fungal infections were diagnosed, with an estimated attributable cost of $6.7 billion. Aspergillus, Pneumocystis, and Candida infections accounted for 76.3% of fungal infections diagnosed, and 81.1% of associated costs. Most fungal disease occurred in patients with elevated risk of infection. The visit costs, lengths of stay, and risks of mortality in this population were more than twice that of those without fungal diagnoses. A further 6.6 million fungal infections were diagnosed during outpatient visits. Conclusions Fungal disease is a serious clinical concern with substantial healthcare costs and significant increases in morbidity and mortality, particularly among predisposed patients. Increased surveillance, standardized treatment guidelines, and improvement in diagnostics and therapeutics are needed to support the rising numbers of at-risk patients.

Evaluation of Physically and/or Chemically Modified Chitosan Hydrogels for Proficient Release of Insoluble Nystatin in Simulated Fluids

“…The prevalence of fungal invasive infections is continuously increasing as a result of the growing number of immunocompromised patients, having an estimated attributable global mortality higher than 1.5 million deaths every year [ 1 , 2 , 3 ]. Superficial mycotic infections caused by Candida species often affect the mucocutaneous tissues (oral or vulvovaginal mucosa) [ 4 , 5 ].…”

Epigenetic Regulation of Antifungal Drug Resistance

“…The mortality rate associated with fungal infections exceeds that of many diseases, including malaria [ 1 , 2 , 3 , 4 ]. A wide range of factors, including an ever-increasing high-risk population (patients with immune suppression, immune dysfunction, diabetes mellitus and patients carrying indwelling catheters or undergoing surgery and organ transplantation), indiscriminate usage of antibiotics, a limited antifungal arsenal and emerging resistance to current antifungal drugs, contribute to the increasing incidence of fungal infections [ 1 , 5 , 6 ]. Species belonging to the Candida genus are the most prevalent agents of hospital-acquired invasive fungal infections, while Aspergillus , Cryptococcus and Penumocystis spp.…”

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