Benedict Kaitlin, Chiller Tom M, Mody Rajal K
Mycotic Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia .
Foodborne Pathog Dis. 2016 Jul;13(7):343-9. doi: 10.1089/fpd.2015.2108. Epub 2016 Apr 13.
Fungi are an integral part of the natural environment and, therefore, play many roles in relation to food: some fungi are used in food production, some are food sources themselves, and some are agents of food spoilage. Some fungi that contaminate food can also be harmful to human health. The harmful but noninfectious health consequences of mycotoxins have been well-characterized, but the extent to which fungi in food pose a risk for invasive infections is unknown. We conducted a literature review to identify cases of invasive fungal infections (IFIs) believed to have resulted from ingestion or inhalation of food, beverages, or dietary supplements (excluding Saccharomyces infections). We identified 11 publications describing cases or small outbreaks of IFIs related to foods or beverages and three describing IFIs related to dietary supplements. These food-associated IFIs were predominantly mold infections, and the few yeast infections were associated with dairy products. Suspected foodborne IFIs appear to be rare, but are increasingly described in the electronically searchable literature. They are associated with a variety of foods, are due to a variety of fungal pathogens, and primarily occur in persons with immunosuppressive conditions or other predisposing factors. Various guidelines for high-risk patients recommend avoidance of certain food products that may contain high levels of fungi, but further work is needed to evaluate the effectiveness of these restrictive diets in preventing fungal infections. The relationships between food spoilage, food insecurity, and IFI risk are another area that may warrant further exploration.
真菌是自然环境中不可或缺的一部分，因此在与食物相关的方面发挥着多种作用：一些真菌用于食品生产，一些本身就是食物来源，还有一些是食物腐败的媒介。一些污染食物的真菌也可能对人类健康有害。霉菌毒素对健康造成的有害但非传染性后果已得到充分描述，但食物中的真菌对侵袭性感染构成风险的程度尚不清楚。我们进行了一项文献综述，以确定据信是由于摄入或吸入食物、饮料或膳食补充剂（不包括酵母菌感染）而导致的侵袭性真菌感染（IFI）病例。我们确定了11篇描述与食物或饮料相关的IFI病例或小规模暴发的出版物，以及3篇描述与膳食补充剂相关的IFI的出版物。这些与食物相关的IFI主要是霉菌感染，少数酵母菌感染与乳制品有关。疑似食源性IFI似乎很少见，但在可电子检索的文献中越来越多地被描述。它们与多种食物有关，由多种真菌病原体引起，主要发生在免疫抑制患者或其他易感因素的人群中。针对高危患者的各种指南建议避免食用某些可能含有大量真菌的食品，但需要进一步开展工作来评估这些限制性饮食在预防真菌感染方面的有效性。食物腐败、粮食不安全与IFI风险之间的关系是另一个可能值得进一步探索的领域。
