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Canadian Journal of Infectious Diseases
Volume 9 (1998), Issue 6, Pages 347-352
http://dx.doi.org/10.1155/1998/473219
Original Article

Invasive Fungal Infections in Canada from 1992 to 1994

LE Nicolle,1 C Rotstein,2 AM Bourgault,3 G St-Germain,4 G Garber,5 and the Canadian Infectious Diseases Society Invasive Fungal Registry

1Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
2Section of Infectious Diseases, Department of Internal Medicine, McMaster University, Hamilton, Ontario, Canada
3Department of Microbiology, St Luc Hospital, Montreal, Quebec, Canada
4Laboratoire de sante publique du Quebec, Montreal, Quebec, Canada
5Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada

Received 14 July 1997; Accepted 26 October 1997

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

PURPOSE: To describe the frequency, characteristics and impact of invasive fungal infection in Canada.

METHODS: Nominal case reporting with standardized data collection from selected sites across Canada. Cases were found primarily through laboratory review with supplementation by record review and clinical surveillance at some sites.

RESULTS: The frequency of invasive fungal infection varied from 3.54 to 6.64/100,000 population per year. Candida species were responsible for 66% of all reports; 80% of candidal infections were bloodstream isolates. Crytococcus neoformans, Aspergillus species and Histoplasma capsulatum each accounted for 5% to 10% of cases, and all other organisms less than 5% each. Human immunodeficiency virus infection was an important comorbidity for cryptococcus and histoplasma infections, and was associated with increased mortality for only histoplasma infections. Geographical variation of histoplasma, blastomyces and coccidioidomyces infection was confirmed. Case fatality was high for all invasive fungal infections, except coccidioidomycosis, blastomycosis and sporotrichosis.

CONCLUSIONS: Candida species infections are the major pathogens in invasive fungal infections in Canada; all other species occur relatively infrequently. The potential for therapeutic intervention to limit mortality requires further assessment.