OBJECTIVE To analyze the epidemiological trends in fungal detection and infection in a tertiary care hospital from 2013 to 2023, and to provide evidence for the prevention and control of fungal infection.
METHODS A total of 26 443 strains of fungi isolated from microbiological culture specimens of all hospitalized patients in the First Affiliated Hospital of Nanjing Medical University from 2013 to 2023 were selected for the study, excluding contaminated specimens and rejecting repeated strains from the same specimens of the same patients, and the epidemiological characteristics were retrospectively analyzed.
RESULTS Of the 26 443 strains of fungi, Pseudohyphae were predominant (94.09%). The detection rate of Pseudohyphae showed an increasing trend before 2020, and a decreasing trend after 2020. The detection rate of molds showed a decreasing trend before 2020 and an increasing trend after 2020 with a statistically significant difference (P < 0.001 for all). Pseudohyphae were dominated by Candida albicans (53.12%), Candida tropicalis (21.86%) and Candida glabrata (19.34%). Molds were dominated by Aspergillus fumigatus (39.97%), Aspergillus aflatus (23.40%) and Aspergillus Niger (6.21%). The 10 000-person detection rates of fungi were 151.98‱, and the 10 000-person detection rates of Pseudohyphae, molds, cryptococcus and spores were 142.99‱, 8.43‱, 0.19‱ and 0.37‱, respectively, among which molds showed a decreasing trend before 2020 and an increasing trend after 2020 (P < 0.001). Fungal infections accounted for 16.33% of all hospital-acquired infections (6 525/39 948), and the proportion showed an increasing trend from 2013 to 2023 (all P < 0.05). The site of hospital-acquired infections caused by fungi were mainly lower respiratory tract infection (50.19%), followed by gastrointestinal tract infection (19.77%) and urinary tract infection (13.69%).
CONCLUSION The proportion of hospital-acquired fungal infections from 2013 to 2023 and the detection of mold since 2020 show significant upward trends, and healthcare institutions should take close attention to the prevention and control of fungal infections in an all-round way.
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