Fungalities associated with drug injection have a particular presentation, and often with yeast species other than Candida albicanswhich requires adapting care. This is the conclusion of a French study identifying all the fungal infections reported in France between 2012 and 2022, namely 9,549, of which 1.9 % was associated with the use of injectable drugs. The results are presented in the Lancet Regional Health – Europe.
Patients affected by fungal infections linked to the use of injectable drugs are younger than the others (45 years in the middle of 66) and have a lower probability of having the risk factors usually associated with fungal. More specifically, they are less at risk of solid or hematological tumors (13.8 % against 49.5 %) or recent surgical history (24.3 % against 37.3 %). Their risk of HIV HIV positive is almost four times higher (12.3 % against 3.6 %).
Compared to “classic” fungal infections, those related to drug injection present a particular clinical picture: the risk of having a deep infection was increased (14.5 % against 3.4 %) and patients suffer from recurring infectious episodes (20.8 % against 4 %). The researchers also noted an overview of target organ damage. In particular, patients had a higher probability of having a prosthetic heart valve (20.8 % against 4.7 %). In addition, 28 % of people with endocarditis during the study period had a history of fungals associated with drug injection. Despite these high risks of morbidity, mortality at 30 and 90 days was lower than for “classic” cases.
Special yeast species
If yeast Candida albicans On all cases of the most frequent fongémies (47.3 %), it is much less present for drug injections infections (30.1 %against 47.6 %) and is often associated with multiPathogenic infections (13.1 %against 4.3 %). We find in particular Meyerozyma guilliermondii in 6 % of cases (against 0.5 %). The researchers also identified a new association between fungal injectable drugs and the species Wickerhamomyces anomaluspresent in 5.5 % of cases (against 0.5 %).
These particular fungalities were more likely to be treated with combined antifungal therapies (9.2 % against 2.4 %). Thus, the authors of the study call to grant particular vigilance to the complications of the target organs, to consider species other than Candida albicans And adopt strategies to prevent recurrences.
