Systemic Fungal Infection
Pp. 173-217 (45)
Norma Lucena-Silva, Juliana Maria Lyra de Azevedo, Heberton Medeiros Teixeira and Moacir Juca
Fungi are responsible for approximately 10% of nosocomial infections, with
Candida spp. being the most prevalent etiological agent. Immunocompromised
individuals are more susceptible to fungal infections. An early determination of the
etiology of the infection is extremely important for these patients because it provides
valuable information for choosing the best therapeutic scheme and may increase the
chances of recovery. Due to the low sensitivity of direct examination, the determination
of the etiology of a fungal infection often requires culture of biological specimens for
isolation and identification of the disease causative agent. Blood culture is not effective
for diagnosis of invasive fungal infections, even when serial specimens are analyzed.
Serological identification of fungal cell wall proteins (galactomannan, mannan,
β-glucan) are considered the first line diagnosis of invasive fungal infections; however,
it has low sensitivity because the antigens are rapidly removed from the bloodstream.
Molecular biology diagnostic methods have been developed as an alternative for the -
detection of fungal infections that are difficult or impossible to detect by conventional
microbiological and serological methods. In this chapter, we provide an up-to-date
review of nosocomial fungal infections, focusing on the occurrence, etiology, risk
factors, clinics, as well as the conventional and molecular methods of diagnosis. We
also discuss the use of molecular markers for the detection of fungal infection.
Aspergillosis, Candidemia, Diagnostic test, Fungi, Invasive fungal
Aggeu Magalhães Research Center of the Oswaldo Cruz Foundation, Brazil.