Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern China
Yingying Gong,1,* Chen Li,1,* Cuicui Wang,2,* Jin Li,1 Meilin Ding,1 Dongying Chen,2 Minxi Lao1,2 1Department of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Rheumatology, The First Affiliated Hospital of Sun Yat...
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Dove Medical Press
2020-03-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/epidemiology-and-mortality-associated-factors-of-invasive-fungal-disea-peer-reviewed-article-IDR |
| _version_ | 1818544538544766976 |
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| author | Gong Y Li C Wang C Li J Ding M Chen D Lao M |
| author_facet | Gong Y Li C Wang C Li J Ding M Chen D Lao M |
| author_sort | Gong Y |
| collection | DOAJ |
| description | Yingying Gong,1,* Chen Li,1,* Cuicui Wang,2,* Jin Li,1 Meilin Ding,1 Dongying Chen,2 Minxi Lao1,2 1Department of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Minxi LaoDepartment of Geriatrics, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Guangzhou 510080, People’s Republic of ChinaEmail laomx3@mail.sysu.edu.cnDongying ChenDepartment of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou 510080, People’s Republic of ChinaEmail cdongying@163.comIntroduction: Invasive fungal disease (IFD) is a life-threatening infection. The epidemiology and clinical features of IFD in the elderly population are less discussed. The aim of this study was to explore the epidemiology and mortality-associated factors for IFD in the elderly inpatients.Methods: A retrospective study enrolling 512 elderly inpatients from The First Affiliated Hospital of Sun Yat-sen University during the last two decades was performed.Results: The annual prevalence of IFD was 0.1– 0.5%. Candidiasis was the most common (236/521, 45.3%). An increasing trend was observed in aspergillosis from 11.1% in year 1998 to 28.8% in year 2018. The common infective sites of candidiasis were abdominal cavity (83/236, 35.2%) and bloodstream (55/236, 23.3%). Invasive aspergillosis mainly developed in the sinus (74/149, 49.7%) and lung (65/149, 43.6%). Patients with diabetes mellitus (DM) (59/126, 46.8%), solid organ malignancy (84/114, 73.7%), chronic kidney disease (CKD) (40/62, 64.5%) or receiving operation (109/147, 74.1%) were prone to develop candidiasis, while aspergillosis was usually complicated in patients with chronic obstructive pulmonary disease (COPD) (25/51, 49.0%). The all-cause mortality rate was 25.9% (135/521), and patients aged ≥ 80 years were the riskiest (20/51, 39.2%). Lymphopenia (59.5% vs 17.3%, P< 0.001) was significant in deceased patients with mold infection. Higher proportion of non-survivors with invasive candidiasis received central venous catheterization (CVC) (68.4% vs 40.6%, P< 0.001) or indwelling urinary catheter (68.4% vs 46.3%, P=0.001).Conclusion: IFD is a life-threatening complication especially in the oldest-old. Surveillance on lymphopenia, prompt treatment and reduce invasive procedures could benefit the prognosis.Keywords: invasive fungal disease, elderly, mortality, hypoalbuminemia |
| first_indexed | 2024-12-11T22:49:49Z |
| format | Article |
| id | doaj.art-16561a81b2c4401bae7c54afac70a0eb |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-12-11T22:49:49Z |
| publishDate | 2020-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-16561a81b2c4401bae7c54afac70a0eb2022-12-22T00:47:30ZengDove Medical PressInfection and Drug Resistance1178-69732020-03-01Volume 1371172352225Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern ChinaGong YLi CWang CLi JDing MChen DLao MYingying Gong,1,* Chen Li,1,* Cuicui Wang,2,* Jin Li,1 Meilin Ding,1 Dongying Chen,2 Minxi Lao1,2 1Department of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Minxi LaoDepartment of Geriatrics, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Guangzhou 510080, People’s Republic of ChinaEmail laomx3@mail.sysu.edu.cnDongying ChenDepartment of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou 510080, People’s Republic of ChinaEmail cdongying@163.comIntroduction: Invasive fungal disease (IFD) is a life-threatening infection. The epidemiology and clinical features of IFD in the elderly population are less discussed. The aim of this study was to explore the epidemiology and mortality-associated factors for IFD in the elderly inpatients.Methods: A retrospective study enrolling 512 elderly inpatients from The First Affiliated Hospital of Sun Yat-sen University during the last two decades was performed.Results: The annual prevalence of IFD was 0.1– 0.5%. Candidiasis was the most common (236/521, 45.3%). An increasing trend was observed in aspergillosis from 11.1% in year 1998 to 28.8% in year 2018. The common infective sites of candidiasis were abdominal cavity (83/236, 35.2%) and bloodstream (55/236, 23.3%). Invasive aspergillosis mainly developed in the sinus (74/149, 49.7%) and lung (65/149, 43.6%). Patients with diabetes mellitus (DM) (59/126, 46.8%), solid organ malignancy (84/114, 73.7%), chronic kidney disease (CKD) (40/62, 64.5%) or receiving operation (109/147, 74.1%) were prone to develop candidiasis, while aspergillosis was usually complicated in patients with chronic obstructive pulmonary disease (COPD) (25/51, 49.0%). The all-cause mortality rate was 25.9% (135/521), and patients aged ≥ 80 years were the riskiest (20/51, 39.2%). Lymphopenia (59.5% vs 17.3%, P< 0.001) was significant in deceased patients with mold infection. Higher proportion of non-survivors with invasive candidiasis received central venous catheterization (CVC) (68.4% vs 40.6%, P< 0.001) or indwelling urinary catheter (68.4% vs 46.3%, P=0.001).Conclusion: IFD is a life-threatening complication especially in the oldest-old. Surveillance on lymphopenia, prompt treatment and reduce invasive procedures could benefit the prognosis.Keywords: invasive fungal disease, elderly, mortality, hypoalbuminemiahttps://www.dovepress.com/epidemiology-and-mortality-associated-factors-of-invasive-fungal-disea-peer-reviewed-article-IDRinvasive fungal diseaseelderlymortalityhypoalbuminemia |
| spellingShingle | Gong Y Li C Wang C Li J Ding M Chen D Lao M Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern China Infection and Drug Resistance invasive fungal disease elderly mortality hypoalbuminemia |
| title | Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern China |
| title_full | Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern China |
| title_fullStr | Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern China |
| title_full_unstemmed | Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern China |
| title_short | Epidemiology and Mortality-Associated Factors of Invasive Fungal Disease in Elderly Patients: A 20-Year Retrospective Study from Southern China |
| title_sort | epidemiology and mortality associated factors of invasive fungal disease in elderly patients a 20 year retrospective study from southern china |
| topic | invasive fungal disease elderly mortality hypoalbuminemia |
| url | https://www.dovepress.com/epidemiology-and-mortality-associated-factors-of-invasive-fungal-disea-peer-reviewed-article-IDR |
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