Impact of the changing epidemiology of fungal infections in the 1990s.

The increase in fungal infections over the past decade is striking. This is particularly true for hospitalized patients where the rate of candidal bloodstream infection has increased by as much as 487% over the decade of the 1980s. This increase in fungal infections is accompanied by a significant excess mortality and excess length of stay in hospital. The emergence of "new" fungal pathogens such as Candida krusei, Torulopsis glabrata, Fusarium and Trichosporon beigelii is now recognized as a significant problem in many patient populations. The documentation of nosocomial transmission of fungal pathogens and the recognition of resistance to both new and established anti-fungal agents poses a significant problem entering the 1990s. Continued effort is needed to develop new and better therapeutic agents and more effective strategies for prophylaxis of endogenous infections and prevention of transmission within the hospital setting.