Emerging and Reemerging Microbial Threats

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Abstract
The incidence of nosocomial fungal infections has been increasing steadily for the past 25 years. Although they were once believed to be of little clinical consequence, there is now compelling evidence that fungal agents represent a bona fide microbial threat with substantial morbidity and high mortality.1,2 Reporting on a series of 30 447 nosocomial fungal infections that occurred in the decade from 1980 to 1990, Beck-Sague and Jarvis3 noted increases in incidence from 90% to 175%. Infection rates rose from 2.0 per 1000 discharges to as high as 6.6 infections per 1000 discharges. Fungal infections increased at all major anatomic sites, including surgical wounds, lung, urinary tract, and bloodstream. Candida species accounted for 78.3% of nosocomial fungal infections, while Torulopsis species and Aspergillus species accounted for 7.3% and 1.3%, respectively. (Arch Surg. 1996;131:330-337)