Sinkó János, Sulyok Mihály, Denning David W
Szent István and Szent László Hospital, Budapest, Hungary.
The University of Manchester, Manchester Academic Health Sciences Centre and the National Aspergillosis Centre, Manchester, UK.
Mycoses. 2015 Oct;58 Suppl 5:29-33. doi: 10.1111/myc.12385.
Valid data on the prevalence of serious fungal diseases are difficult to derive as in most countries these conditions are not reportable infections. To assess the burden of these infections in Hungary prevalence estimates from international peer-reviewed papers and population statistics were utilised. In the intensive care unit (ICU) population at least 370 cases of serious yeast and 52 mould infections can be expected yearly. The total number of candidaemia cases may be as high as 1110 annually. In patients with acute leukaemia and recipients of haematopoietic stem cell and solid organ transplants the predicted incidence is more than 55 every year. Recurrent vulvovaginal candidiasis--though not a life-threatening condition--can adversely affect the quality of life of more than 177,000 Hungarian women. According to organisation for economic co-operation and development (OECD), 4.7% of total population older than 15 will suffer from chronic obstructive pulmonary disease (COPD) and 4.4% from asthma, adding another very broad risk group to the aforementioned categories susceptible for mycotic complications. Here more than 17,000 can have severe asthma with fungal sensitisation (SAFS) and more than 13,000 are at risk for developing allergic bronchopulmonary aspergillosis (ABPA). The incidence of dermatomycoses and other superficial fungal infections is even more difficult to assess but--according to international estimations--can affect around 14.3% of the total population. More than 1.6 million Hungarians may suffer from fungal diseases annually, with 33,000 cases being life threatening or very serious. This is an under-recognised problem of special importance for public health.
由于在大多数国家,严重真菌病并非法定报告传染病,因此难以获取有关其患病率的有效数据。为评估匈牙利这些感染的负担,我们利用了国际同行评审论文中的患病率估计值和人口统计数据。在重症监护病房(ICU)人群中,预计每年至少有370例严重酵母菌感染和52例霉菌感染。念珠菌血症病例总数每年可能高达1110例。在急性白血病患者以及造血干细胞和实体器官移植受者中,预计每年发病率超过55例。复发性外阴阴道念珠菌病——尽管并非危及生命的疾病——但可能对超过17.7万匈牙利女性的生活质量产生不利影响。根据经济合作与发展组织(OECD)的数据,15岁以上总人口的4.7%将患有慢性阻塞性肺疾病(COPD),4.4%将患有哮喘,这为上述易发生真菌并发症的类别又增加了一个非常广泛的风险群体。在这里,超过1.7万人可能患有真菌致敏严重哮喘(SAFS),超过1.3万人有患变应性支气管肺曲霉病(ABPA)的风险。皮肤真菌病和其他浅表真菌感染的发病率更难评估,但根据国际估计,可能影响约14.3%的总人口。每年可能有超过160万匈牙利人患有真菌病,其中3.3万例危及生命或非常严重。这是一个对公共卫生特别重要但未得到充分认识的问题。