Epidemiology and Management of Invasive Fungal Infections
Summary
Invasive fungal infections constitute a growing global health challenge, affecting patients with weakened immune systems, prolonged hospital stays and indwelling devices. The most common syndromes include candidemia, invasive aspergillosis and mucormycosis, each driven by distinct fungal species and host risk factors. Incidence has risen in parallel with advances in critical care, transplantation and cancer therapies, yet remains underappreciated in many regions. Key determinants of risk include broad-spectrum antibiotic use, central venous catheters, neutropaenia and intensive care unit admission. Geographic variation in species distribution and antifungal resistance underscores the need for local surveillance. Management emphasises early diagnosis, source control and prompt initiation of appropriate antifungal therapy. Conventional culture methods are complemented by non-cultural assays such as beta-D-glucan testing and emerging molecular platforms. First-line treatments are typically echinocandins or azoles, guided by species identification and susceptibility profiles. Stewardship of existing agents, alongside the development of novel therapies and vaccines, is vital to curb mortality rates that can exceed 30% in high-risk cohorts. Integrated public health strategies are required to standardise surveillance, optimise antifungal use and raise awareness of invasive fungal disease burden worldwide.
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Epidemiology and Management of Invasive Fungal Infections publication trend
The graph below shows the total number of articles in epidemiology and management of invasive fungal infections across all publications each year (not limited to Nature Index journals).
Technical terms
Invasive fungal infection (IFI): A deep-seated or bloodstream infection caused by pathogenic fungi that breach host barriers.
Candidemia: Presence of Candida species in the bloodstream leading to systemic infection and high mortality.
Echinocandins: A class of antifungal agents that inhibit synthesis of β-1,3-D-glucan in the fungal cell wall.
Azoles: Antifungal drugs targeting ergosterol synthesis in fungal cell membranes.
Beta-D-glucan assay: A non-cultural diagnostic test detecting a fungal cell wall component to support early diagnosis.
T2Candida assay: A molecular diagnostic platform that detects Candida DNA directly from blood samples without culture.
References
- Population-Based Active Surveillance for Culture-Confirmed Candidemia — Four Sites, United States, 2012–2016. MMWR Surveillance Summaries (2019).
- Diagnosis and Treatment of Invasive Candidiasis. Antibiotics (2022).
- Fungal diseases as neglected pathogens: A wake-up call to public health officials. PLOS Neglected Tropical Diseases (2020).
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