CAMBIOS EN LA EPIDEMIOLOGIA DE LAS INFECCIONES MICOTICAS INVASIVAS

Se describe un cambio en la epidemiología de las infecciones micóticas invasivas en los últimos años, con un creciente incremento de la importancia de nuevos patógenos que se han convertido en agentes asociados con elevada mortalidad en pacientes inmunocomprometidos.

Autor:
Cornelia Lass-flörl
Columnista Experta de SIIC

Institución:
Innsbruck Medical University

Artículos publicados por Cornelia Lass-flörl

Coautor
Gerhard Blum*
Innsbruck Medical University, Innsbruck, Austria*

Recepción del artículo
31 de Enero, 2011

Aprobación
15 de Abril, 2011

Primera edición
12 de Septiembre, 2011

Segunda edición, ampliada y corregida
7 de Junio, 2021

CAMBIOS EN LA EPIDEMIOLOGIA DE LAS INFECCIONES MICOTICAS INVASIVAS

Resumen
Las infecciones micóticas invasivas (IMI) constituyen una importante causa de morbimortalidad, en especial en los pacientes con factores de riesgo subyacentes (neutropenia, quimioterapia, trasplante, sida). Las especies de los géneros Candida y Aspergillus representan aun las causas relevantes de IMI, pero otros organismos están adquiriendo importancia creciente. Han surgido especies del género Aspergillus menos sensibles a los antifúngicos y se ha encontrado resistencia a los azólicos, especialmente en Aspergillus fumigatus. Asimismo, las infecciones debidas a especies de los géneros Trichosporon, Fusarium y Glomeromycota (antes llamado Zygomycetes) se han incrementado y se asocian con altas tasas de mortalidad. Algunas de estas infecciones emergentes se presentan como brotes durante el tratamiento con nuevos antifúngicos, como las equinocandinas o los azólicos. La incidencia, gravedad y pronóstico de las IMI dependen de manera acentuada del organismo causal, el estado del paciente, el nivel de inmunosupresión y la localización geográfica. El diagnóstico precoz y el reconocimiento de estos cambios epidemiológicos son críticos para la atención de los pacientes.

Palabras clave
epidemiología, infecciones micóticas, factores de riesgo

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Epidemiology of fungal infections

Abstract
Invasive fungal infections (IFIs) are an important cause of morbidity and mortality, particularly in patients with underlying risk factors (e.g., neutropenia, cancer chemotherapy, transplantation, AIDS). Candida species and Aspergillus species remain the relevant causes of IFI but other organisms become increasingly important. Aspergilli, less susceptible to antifungals emerge and resistance to azoles has been found mainly in Aspergillus fumigatus. Also, infections due to Trichosporon species, Fusarium species and Glomeromycota (formerly Zygomycetes) are increasing and are associated with a high mortality rate. Some of these emerging infections occur as breakthrough infections during treatment with new antifungals such as the echinocandins and azoles. The incidence, severity and outcome of IFIs is largely influenced by the causative organism, underlying condition, state of immunosuppression, and the geographic location. Early diagnosis and recognition of these epidemiologic changes is critical to patient care.

Key words
epidemiology, fungal infections, risk factors

Full text
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para suscriptores/ assinantes

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Especialidades
Principal: Epidemiología, Infectología
Relacionadas: Bioquímica, Cuidados Intensivos, Diabetología, Diagnóstico por Laboratorio, Geriatría, Hematología, Inmunología, Medicina Interna, Trasplantes

Enviar correspondencia a:
Cornelia Lass-Flörl, Innsbruck Medical University Division of Hygiene and Medical Microbiology, 6020, Fritz Pregl Str. 3/III, Innsbruck, Austria

Bibliografía del artículo
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