Epidemiology of Clinical Mold Infections in China: A Multicenter Retrospective Study

Objective To study the epidemiology of mold infections in China. Methods Based on the surveillance data of 19 hospitals participating in the China Hospital Invasive Fungal Surveillance Net from Jan 2019 to Jun 2022, the general information of patients and the epidemiological characteristics such as the proportion of different strains and clinical infection were analyzed by WHONET software. Results A total of 16 285 mold infection cases were included in the analysis, of which 49.3% were patients aged 61 and over, with the median age of 60 years old. The proportion of males was significantly higher than that of females (62.1% vs. 37.9%). The patients were mainly from the internal medicine, ICU and surgical wards. Most strains were isolated from lower respiratory tract, accounting for 81.7%, followed by pus and secretions (7.8%). In terms of species distribution, Aspergillus spp. accounted for the highest proportion (84.8%), with Penicillium spp., Fusarium spp., order Mucorales and Sedosporium spp. accounting for 5.1%, 3.0%, 1.3% and 0.4%, respectively. For species distribution among different mold infection, 88.7% of lower respiratory tract mold infections were caused by Aspergillus spp., and Aspergillus fumigatus(47.8%) was the most common species. Otomycosis was mainly caused by Aspergillus spp.(98.7%), of which Aspergillus terreus accounted for 39.7%, and ophthalmomycosis was mainly caused by Fusarium spp.(54.6%). Conclusions By the retrospective analysis of mold isolation from multicenter in China, we found that Aspergillus fumigatus, Aspergillus terreus, and Fusarium spp. were the most common species causing pneumonomycosis, otomycosis, and ophthalmomycosis, respectively. Therefore, it is necessary to pay attention to the differences in species distribution among different mold infections in clinical empirical treatment of fungal infections.