Epidemiology of Pulmonary Aspergillosis in Hospitalized Patients in Poland During 2009-2016.

Aspergillus is one of the most prevalent airborne fungal pathogens in the developed countries that may cause fatal invasive pulmonary aspergillosis in immunocompromised patients. The epidemiological information on aspergillosis in Poland is scarce. This retrospective, population-based study evaluated the incidence of pulmonary and other forms of aspergillosis, and also gender distribution and territorial differences in the occurrence of aspergillosis in hospitalized patients in Poland during 2009-2016. The incidence of aspergillosis was estimated on the basis of a dataset provided by hospital morbidity study carried out by the National Institute of Public Health. The data consisted of 4206 hospitalization records of 2338 patients, with some patients being hospitalized more than one time due to disease remissions. Significant gender differences were observed (1484 females vs. 2722 males, p < 0.001). No statistical differences were found for the place of residence. The average annual incidence rates for all forms of aspergillosis, invasive pulmonary aspergillosis, and other pulmonary aspergillosis were 13.8 per million (95% CI: 11.3-16.3), 4.0 per million (95% CI: 3.0-5.0), and 4.4 (CI: 3.5-5.2) per million, respectively. Over time, a significant increase in the rate of hospitalization were observed for all forms of aspergillosis (10.7 per million in 2009 vs. 15.7 per million in 2016, p for trend <0.005), invasive pulmonary aspergillosis (2.3 per million in 2009 vs. 5.0 per million in 2016, p for trend <0.001), and other pulmonary aspergillosis (3.6 per million in 2009 vs. 4.9 per million in 2016, P for trend <0.02). During the period analyzed 283 patients (12.0%) died while hospitalized and 224 of them (9.6% of all patients) died during the first-time hospitalization. We conclude that the incidence of aspergillosis is on the rise in hospitalized patients in Poland.