CHALLENGES ON INVASIVE FUNGAL INFECTIONS POSSIBLY ASSOCIATED WITH HEALTHCARE

Background and Aims. Healthcare associated infections are one of the most frequent events threatening patients' safety worldwide. Invasive fungal infections usually occur in immunosuppressed people. These events raise significant medicolegal issues regarding the responsibility to protect the population from harm. The aim of this study was to reduce the medicolegal implications of the invasive fungal pathology possible associated with healthcare in the context of the complexities of the current medical practice. Methods. A cross-sectional study was developed in order to evaluate the invasive fungal infections among patients hospitalized in an Infectious Diseases Department between January 2010 and December 2016. Results. 211,609 patients were hospitalized in an Infectious Diseases Department, between January 2010 and December 2016. Among these subjects we identified 79 cases with IFI (which correspond to a frequency of 37.3 cases per 100,000 population). The most frequent fungal pathogens were Candida spp. (78.16%). The current analysis showed that the factors with a significant influence on IFI mortality included: age (p = 0.0002), HIV positive status (p = 0.0012), organ failure (p = 0.0142), and a low value of hemoglobin (p < 0.0001). Conclusion. Often it is possible and probable that an invasive fungal infection to be associated with healthcare, which is the result of synergic actions of a complex of factors that involved the healthcare providers (healthcare workers), the environment (hospitals or other healthcare associated settings), and the host (immunosuppressed or not). In these conditions medicolegal issues may arise.