Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
Mycoses. 2019 Nov;62(11):1043-1048. doi: 10.1111/myc.12981. Epub 2019 Aug 25.
The aim of this study was to estimate the annual burden of fungal infections in Sweden using data mainly from 2016. Data on specific populations were obtained from Swedish national data registries. Annual incidence and prevalence of fungal disease was calculated based on epidemiological studies. Data on infections due to Cryptococcus sp., Mucorales, Histoplasma capsulatum, Coccidioides immitis and Pneumocystis jirovecii were retrieved from Karolinska University Laboratory and covers only 25% of Swedish population. In 2016, the population of Sweden was 9 995 153 (49.8% female). The overall burden of fungal infections was 1 713 385 (17 142/100 000). Superficial fungal infections affect 1 429 307 people (1429/100 000) based on Global Burden of Disease 14.3% prevalence. Total serious fungal infection burden was 284 174 (2843/100 000) in 2016. Recurrent Candida vulvovaginitis is common; assuming a 6% prevalence in women. Prevalence of allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation were estimated to be 20 095 and 26 387, respectively. Similarly, chronic pulmonary aspergillosis was estimated to affect 490 patients after tuberculosis, sarcoidosis and other conditions. Candidemia incidence was estimated to be 500 in 2016 (4.7/100 000) and invasive aspergillosis 295 (3.0/100 000). In Stockholm area, Mucorales were reported in three patients in 2015, while Cryptococcus spp. were reported in two patients. In 2016, there were 297 patients PCR positive for P jirovecii. The present study shows that the overall burden of fungal infections in Sweden is high and affects 17% of the population. The morbidity, mortality and the healthcare-related costs due to fungal infections warrant further studies.
本研究旨在利用主要来自 2016 年的数据，估算瑞典真菌感染的年度负担。特定人群的数据来自瑞典国家数据登记处。真菌病的年发病率和患病率是根据流行病学研究计算得出的。从卡罗林斯卡大学实验室检索到的关于新型隐球菌、毛霉科、荚膜组织胞浆菌、粗球孢子菌和卡氏肺孢子菌感染的数据仅涵盖瑞典人口的 25%。2016 年，瑞典人口为 9995153 人（49.8%为女性）。真菌感染的总负担为 1713385 人（17142/100000）。根据全球疾病负担 14.3%的患病率，估计有 1429307 人（1429/100000）患有浅表真菌感染。2016 年总严重真菌感染负担为 284174 人（2843/100000）。复发性阴道假丝酵母菌病很常见；假设女性患病率为 6%。过敏性支气管曲霉病和真菌致敏严重哮喘的患病率估计分别为 20095 人和 26387 人。同样，据估计，肺结核、结节病和其他疾病后有 490 名患者患有慢性肺曲霉病。2016 年估计有 500 例念珠菌血症（500/100000）和 295 例侵袭性曲霉病（295/100000）。2015 年，斯德哥尔摩地区报告了 3 例毛霉科感染病例，而新型隐球菌感染报告了 2 例。2016 年，有 297 名患者 PCR 检测卡氏肺孢子菌阳性。本研究表明，瑞典真菌感染的总体负担很高，影响了 17%的人口。真菌感染的发病率、死亡率和与医疗保健相关的费用需要进一步研究。
