Abstract
Healthcare-associated infections (HAI) are described in diverse settings. The main etiologic agents of HAI are bacteria (85%) and fungi (13%). Some factors increase the risk for HAI, particularly the use of medical devices; patients with severe cuts, wounds, and burns; stays in the intensive care unit, surgery, and hospital reconstruction works. Several fungal HAI are caused by Candida spp., usually from an endogenous source; however, cross-transmission via the hands of healthcare workers or contaminated devices can occur. Although other medically important fungi, such as Blastomyces dermatitidis, Paracoccidioides brasiliensis, and Histoplasma capsulatum, have never been considered nosocomial pathogens, there are some factors that point out the pros and cons for this possibility. Among these fungi, H. capsulatum infection has been linked to different medical devices and surgery implants. The filamentous form of H. capsulatum may be present in hospital settings, as this fungus adapts to different types of climates and has great dispersion ability. Although conventional pathogen identification techniques have never identified H. capsulatum in the hospital environment, molecular biology procedures could be useful in this setting. More research on H. capsulatum as a HAI etiologic agent is needed, since it causes a severe and often fatal disease in immunocompromised patients.
Highlights
The term healthcare-associated infection (HAI) refers to infections associated with healthcare delivery in any setting
H. capsulatum shares some features with the etiologic agents of Healthcare-associated infections (HAI), bacteria or fungi, which support the nosocomial involvement of H. capsulatum infection: worldwide distribution, its ubiquity, production of aerosolized infective propagules that spread the fungus in the environment and favor the infection by the respiratory pathway, development of biofilm and quorumsensing (QS) events, and opportunistic behavior in immunosuppressed hosts
H. capsulatum infection associated with healthcare has been linked to medical devices and surgical implants
Summary
The term healthcare-associated infection (HAI) refers to infections associated with healthcare delivery in any setting (e.g., hospitals, long-term care facilities, ambulatory settings, and home care). This term reflects the inability to determine with certainty where the pathogen is acquired since patients may be colonized or exposed to potential pathogens outside the healthcare setting, before receiving healthcare or during healthcare delivery [1, 2]. HAI commonly occur by direct transmission from individual to individual or through fomites manipulated by healthcare workers, as well as through surfaces and devices contaminated by biofilms (surgical instruments, catheters, BioMed Research International mechanical ventilation systems, and others) [5, 6]. The aims of this paper were to review the reported cases of H. capsulatum infections in healthcare settings, in order to propose the different factors that could be related to healthcare-associated histoplasmosis and discuss the features that could favor the presence of this fungus in the hospital environment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
