The use of amphotericin B in nosocomial fungal infection.

The use of potent broad-spectrum antibacterial agents, the increasing number of immunocompromised hosts, and the use of invasive treatment modalities have exacerbated the problems involved in the management of nosocomial fungal infection. The hospital records at a tertiary-care medical center were retrospectively reviewed in an effort to determine the magnitude of these problems. A plethora of fungal species were isolated from patients. Hospital infection surveillance revealed between 30 and 40 nosocomial yeast infections per month, with 20% of nosocomial urinary tract infections caused by yeasts rather than by bacterial pathogens and one or two cases of fungemia per week. Although these figures represent a large number of nosocomial fungal infections, a significant increase in the number of such infections over the last several years could not be documented. The use of amphotericin B was found to have increased each year. The patterns of use of amphotericin B changed little between 1983 and 1987, but the number of patients treated with this agent increased dramatically.