Epidemiology, the Impact of COVID-19, and the Mycological Approach in Invasive Mold Infection

Abstract

Invasive fungal infections are a significant health challenge worldwide. Although invasive yeast infections are more prevalent, invasive mold infections (IMIs), such as Aspergillus spp., Mucorales, and Fusarium spp., are rising. The increase in IMIs is attributed to various factors, such as transplantation, aggressive treatments, invasive medical devices, and the emergence of new at-risk populations, such as patients with influenza and SARS-CoV-2-associated aspergillosis. The European Organization for Research and Treatment of Cancer and the Mycosis Study Group initially provided definitions based on host and clinical factors, including radiological findings and mycological evidence. The recent 2020 updates of the definitions state that a case confirmed by microscopy, histopathology, and culture from a sterile site is "proven"; however, regarding mycological criteria, this guideline introduced revised thresholds for the galactomannan assay based on sample types, excluded the 1,3-β-D-glucan detection assay, and acknowledged positive Aspergillus polymerase chain reaction tests from serum, plasma, or bronchoalveolar lavage fluid. The current diagnostic approach improves the accuracy and timeliness of diagnosing fungal infections and facilitates more effective patient management.