Epidemiology of opportunistic invasive fungal infections in China: review of literature.

Objective: To summarize the recent findings on the epidemiology of medically important, opportunistic invasive fungal infections (IFIs) in China and discuss the relevant social, economical reasons and medical factors.

Data Sources: We performed a comprehensive search of both English and Chinese literatures of opportunistic IFIs from China up to April 2012.

Study Selection: Relevant literatures involving researches and cases/case series were identified, retrieved and reviewed.

Results: The incidence of opportunistic IFIs in China was steadily increasing. The incidence and mortality of IFIs were different in patients with various underlying conditions/diseases, from 4.12% to 41.18% and 9.8% to 60.0%, respectively. Candida species, Aspergillus species and Cryptococcus neoformans species complex were the most frequent isolated pathogens. Other uncommon opportunistic IFIs were also been reported, including trichosporonosis, mucormycosis, hyalohyphomycosis (hyaline hyphomycetes) and phaeohyphomycosis (dematiaceous hyphomycetes). Reports of Chinese patients differed from those of many other countries as there were a higher number of patients without identifiable underlying diseases/conditions.

Conclusions: Because of the rapid economic development, changing population structure and a growing number of immunocompromised hosts with risk factors, today opportunistic IFIs in China have a significant impact on public health, associated with high morbidity/mortality and higher care costs. Now information related to the epidemiology of opportunistic IFIs in China is still sparse, so we need more organized groups of clinical scientists performing related researches to help the clinicians to obtain more accurate epidemiological characteristics.