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Serious fungal infections in Portugal

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Abstract

There is a lack of knowledge on the epidemiology of fungal infections worldwide because there are no reporting obligations. The aim of this study was to estimate the burden of fungal disease in Portugal as part of a global fungal burden project. Most published epidemiology papers reporting fungal infection rates from Portugal were identified. Where no data existed, specific populations at risk and fungal infection frequencies in those populations were used in order to estimate national incidence or prevalence, depending on the condition. An estimated 1,510,391 persons develop a skin or nail fungal infection each year. The second most common fungal infection in Portugal is recurrent vulvovaginal candidiasis, with an estimated 150,700 women (15–50 years of age) suffering from it every year. In human immunodeficiency virus (HIV)-infected people, oral or oesophageal candidiasis rates were estimated to be 19.5 and 16.8/100,000, respectively. Candidaemia affects 2.19/100,000 patients, in a total of 231 cases nationally. Invasive aspergillosis is less common than in other countries as chronic obstructive pulmonary disease (COPD) is uncommon in Portugal, a total of 240 cases annually. The estimated prevalence of chronic pulmonary aspergillosis after tuberculosis (TB) is 194 cases, whereas its prevalence for all underlying pulmonary conditions was 776 patients. Asthma is common (10% in adults) and we estimate 16,614 and 12,600 people with severe asthma with fungal sensitisation and allergic bronchopulmonary aspergillosis, respectively. Sixty-five patients develop Pneumocystis pneumonia in acquired immune deficiency syndrome (AIDS) and 13 develop cryptococcosis. Overall, we estimate a total number of 1,695,514 fungal infections starting each year in Portugal.

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References

  1. Statistics Portugal. Censos 2011. Home page at: http://censos.ine.pt. Accessed 20 May 2016

  2. European Centre for Disease Prevention and Control/WHO Regional Office for Europe (2015) Tuberculosis surveillanceand monitoring in Europe2015. Available online at: http://ecdc.europa.eu/en/publications/Publications/tuberculosis-surveillance-monitoring-Europe-2015.pdf. Accessed 25 May 2016

  3. Portugal - Doenças Oncológicas em números - 2014. Available online at: https://www.dgs.pt/estatisticas-de-saude/estatisticas-de-saude/publicacoes/portugal-doencas-oncologicas-em-numeros-2014.aspx. Accessed 3 June–August 2016

  4. LIFE — Worldwide. Home page at: http://www.life-worldwide.org/. Accessed 11 August 2016

  5. Rodriguez-Tudela JL, Alastruey-Izquierdo A, Gago S, Cuenca-Estrella M, León C, Miro JM, Nuñez Boluda A, Ruiz Camps I, Sole A, Denning DW; University of Manchester in association with the LIFE program (2015) Burden of serious fungal infections in Spain. Clin Microbiol Infect 21:183–189. doi:10.1016/j.cmi.2014.07.013

    Article  CAS  PubMed  Google Scholar 

  6. Statistics Portugal. Home page at: https://www.ine.pt. Accessed 20 May 2016

  7. Infeção VIH/SIDA: a situação em Portugal a 31 de dezembro de 2014. Available online at: http://repositorio.insa.pt/bitstream/10400.18/3205/3/Relat%C3%B3rio%20VIH_SIDA_2014.pdf. Accessed 25 May 2016

  8. República PortuguesaDireção-Geral da Saúde. Histórico de Destaques.Apresentação Pública do Relatório «Portugal em números 2015 – Infeção VIH, SIDA e Tuberculose». Available online at: http://www.dgs.pt/?cr=29118. Accessed 25 May 2016

  9. World Health Organization (WHO). Tuberculosis country profiles. Available online at: http://www.who.int/tb/country/data/profiles. Accessed 25 May 2016

  10. World Health Organization (WHO). Global tuberculosis report 2016. Available online at: http://www.who.int/tb/publications/global_report/en. Accessed 25 May 2016

  11. Instituto Português do Sangue e Transplantação (IPST). Home page at: http://ipst.pt. Accessed 3 June 2016

  12. Administração Central do Sistema de Saúde. Home page at: http://www.acss.min-saude.pt. Accessed 11 August 2016

  13. Histórico de Destaques.Portugal - Doenças Respiratórias em Números 2015. Available online at: https://www.dgs.pt/em-destaque/portugal-doencas-respiratorias-em-numeros-20151.aspx. Accessed 27 May 2016

  14. Sa-Sousa A, Morais-Almeida M, Azevedo LF, Carvalho R, Jacinto T, Todo-Bom A, Loureiro C, Bugalho-Almeida A, Bousquet J, Fonseca JA (2012) Prevalence of asthma in Portugal - the Portuguese National Asthma Survey. Clin Transl Allergy 2:15. doi:10.1186/2045-7022-2-15

    Article  PubMed  PubMed Central  Google Scholar 

  15. Doença Pulmonar Obstrutiva Crónica (DPOC). Available online at: http://dpoc.pt/dpoc-em-portugal. Accessed 27 May 2016

  16. 5.1.2 COPD hospital admission rates, population aged 15 and over, 2009 (or nearest year). Available online at: http://www.oecd.org/els/health-systems/49078977.xls. Accessed 25 May 2016

  17. Bárbara C, Rodrigues F, Dias H, Cardoso J, Almeida J, Matos MJ, Simão P, Santos M, Ferreira JR, Gaspar M, Gnatiuc L, Burney P (2013) Chronic obstructive pulmonary disease prevalence in Lisbon, Portugal: the burden of obstructive lung disease study. Rev Port Pneumol 19:96–105. doi:10.1016/j.rppneu.2012.11.004

    Article  PubMed  Google Scholar 

  18. Silva A, Amorim A, Azevedo P, Lopes C, Gamboa F (2016) Cystic fibrosis—characterization of the adult population in Portugal. Rev Port Pneumol 22:141–145. doi:10.1016/j.rppnen.2015.12.010

    CAS  PubMed  Google Scholar 

  19. Denning DW, Pleuvry A, Cole DC (2011) Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis. Bull World Health Organ 89:864–872. doi:10.2471/BLT.11.089441

    Article  PubMed  PubMed Central  Google Scholar 

  20. Veríssimo C, Brandão J, Simões HL, Sabino R (2015) Dermatophyte infections in the Lisbon and Tagus valley. Mycoses 58:220–221, Abstract

    Article  Google Scholar 

  21. Valdigem GL, Pereira T, Macedo C, Duarte ML, Oliveira P, Ludovico P, Sousa-Basto A, Leão C, Rodrigues F (2006) A twenty-year survey of dermatophytoses in Braga, Portugal. Int J Dermatol 45:822–827

    Article  CAS  PubMed  Google Scholar 

  22. World Health Organization (WHO). Home page at: http://www.who.int. Accessed 25 May 2016

  23. Organisation for Economic Co-operation and Development (OECD) (2015) OECD reviews of health care quality: Portugal 2015: raising standards. OECD Publishing, Paris

    Google Scholar 

  24. Lagrou K, Maertens J, Van Even E, Denning DW (2015) Burden of serious fungal infections in Belgium. Mycoses 58(Suppl 5):1–5. doi:10.1111/myc.12389

    Article  PubMed  Google Scholar 

  25. Chrdle A, Mallátová N, Vašáková M, Haber J, Denning DW (2015) Burden of serious fungal infections in the Czech Republic. Mycoses 58:6–14. doi:10.1111/myc.12384

    Article  PubMed  Google Scholar 

  26. Armstead J, Morris J, Denning DW (2014) Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis. PLoS One 9:e98502. doi:10.1371/journal.pone.0098502, eCollection 2014

    Article  PubMed  PubMed Central  Google Scholar 

  27. Boas Práticas e Orientações para o Controlo da Asma no Adulto e na Criança - 2ª Edição. Available online at: https://www.dgs.pt/documentos-e-publicacoes/boas-praticas-e-orientacoes-para-o-controlo-da-asma-no-adulto-e-na-crianca-2-edicao.aspx. Accessed 5 June 2016

  28. Denning DW, Pleuvry A, Cole DC (2013) Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults. Med Mycol 51:361–370

    Article  PubMed  Google Scholar 

  29. Denning DW, O’Driscoll BR, Hogaboam CM, Bowyer P, Niven RM (2006) The link between fungi and severe asthma: a summary of the evidence. Eur Respir J 27:615–626

    Article  CAS  PubMed  Google Scholar 

  30. Denning DW, Cadranel J, Beigelman-Aubry C, Ader F, Chakrabarti A, Blot S, Ullmann AJ, Dimopoulos G, Lange C; European Society for Clinical Microbiology and Infectious Diseases and European Respiratory Society (2016) Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J 47:45–68. doi:10.1183/13993003.00583-2015

    Article  CAS  PubMed  Google Scholar 

  31. Yan X, Li M, Jiang M, Zou L-Q, Luo F, Jiang Y (2009) Clinical characteristics of 45 patients with invasive pulmonary aspergillosis: retrospective analysis of 1711 lung cancer cases. Cancer 115:5018–5025. doi:10.1002/cncr.24559

    Article  PubMed  Google Scholar 

  32. Grupo de Estudo do Cancro do Pulmão. Home page at: http://www.gecp.pt. Accessed 10 August 2016

  33. Herbrecht R, Bories P, Moulin JC, Ledoux MP, Letscher-Bru V (2012) Risk stratification for invasive aspergillosis in immunocompromised patients. Ann N Y Acad Sci 1272:23–30

    Article  PubMed  Google Scholar 

  34. Faria-Ramos I, Neves-Maia J, Ricardo E, Santos-Antunes J, Silva AT, Costa-de-Oliveira S, Cantón E, Rodrigues AG, Pina-Vaz C (2014) Species distribution and in vitro antifungal susceptibility profiles of yeast isolates from invasive infections during a Portuguese multicenter survey. Eur J Clin Microbiol Infect Dis 33:2241–2247. doi:10.1007/s10096-014-2194-8

    Article  CAS  PubMed  Google Scholar 

  35. Nguyen MH, Wissel MC, Shields RK, Salomoni MA, Hao B, Press EG, Shields RM, Cheng S, Mitsani D, Vadnerkar A, Silveira FP, Kleiboeker SB, Clancy CJ (2012) Performance of Candida real-time polymerase chain reaction, β-D-glucan assay, and blood cultures in the diagnosis of invasive candidiasis. Clin Infect Dis 54:1240–1248. doi:10.1093/cid/cis200

    Article  CAS  PubMed  Google Scholar 

  36. Buchacz K, Baker RK, Palella FJ Jr, Chmiel JS, Lichtenstein KA, Novak RM, Wood KC, Brooks JT; HOPS Investigators (2010) AIDS-defining opportunistic illnesses in US patients, 1994–2007: a cohort study. AIDS 24:1549–1559

    Article  PubMed  Google Scholar 

  37. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2163–2196

    Article  PubMed  Google Scholar 

  38. Torres-Narbona M, Guinea J, Martínez-Alarcón J, Muñoz P, Gadea I, Bouza E; MYCOMED Zygomycosis Study Group (2007) Impact of zygomycosis on microbiology workload: a survey study in Spain. J Clin Microbiol 45:2051–2053

    Article  PubMed  PubMed Central  Google Scholar 

  39. Bitar D, Van Cauteren D, Lanternier F, Dannaoui E, Che D, Dromer F, Desenclos J-C, Lortholary O (2009) Increasing incidence of zygomycosis (mucormycosis), France, 1997–2006. Emerg Infect Dis 15:1395–1401

    Article  PubMed  PubMed Central  Google Scholar 

  40. Diabetes: factos e números 2014. Relatório anual do observatório nacional da diabetes. Direção Geral de Saúde, 11/2014. Accessed 25 June 2016

  41. Gascón J, Torres JM, Jiménez M, Mejias T, Triviño L, Gobbi F, Quintó L, Puig J, Corachan M (2005) Histoplasmosis infection in Spanish travelers to Latin America. Eur J Clin Microbiol Infect Dis 24:839–841

    Article  PubMed  Google Scholar 

  42. Lopes MJ, Batista J, Trigo D, Cunha J, Pacheco P (2015) Histoplasmose africana: Apresentação atípica 40 anos após exposição. 14° Encontro Nacional de Atualização em infeciologia. 4–16 Outubro 2015, Porto, Portugal

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Acknowledgements

The authors thank Rita Roquette for her assistance in consulting the Diagnostic Homogeneous Groups database, made available by the Central Administration of the Health System.

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Authors and Affiliations

  1. Infectious Diseases Department, National Institute of Health Dr. Ricardo Jorge—Reference Unit for Parasitic and Fungal Infections, Lisbon, Portugal

    R. Sabino, C. Verissímo & J. Brandão

  2. Centro Hospitalar Lisboa-Norte, EPE, Lisbon, Portugal

    C. Martins & D. Alves

  3. Department of Biology, Centre of Molecular and Environmental Biology (CBMA), University of Minho, Braga, Portugal

    C. Pais

  4. The University of Manchester and National Aspergillosis Centre, University Hospital of South Manchester, Manchester, UK

    D. W. Denning

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  1. R. Sabino
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  2. C. Verissímo
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  5. D. Alves
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  6. C. Pais
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Correspondence to R. Sabino.

Additional information

In association with the LIFE program at http://www.LIFE-worldwide.org

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Sabino, R., Verissímo, C., Brandão, J. et al. Serious fungal infections in Portugal. Eur J Clin Microbiol Infect Dis 36, 1345–1352 (2017). https://doi.org/10.1007/s10096-017-2930-y

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