{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:09:41Z","timestamp":1791500981516,"version":"4.3.4"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T00:00:00Z","timestamp":1532995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007705","name":"Astellas Pharma Global Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007705","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A better understanding of the epidemiology and clinical features of invasive fungal infection (IFI) is integral to improving outcomes. We describe a novel case-finding methodology, reporting incidence, clinical features, and outcomes of IFI in a large US health care network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All available records in the Intermountain Healthcare Enterprise Data Warehouse from 2006 to 2015 were queried for clinical data associated with IFI. The resulting data were overlaid in 124 different combinations to identify high-probability IFI cases. The cohort was manually reviewed, and exclusions were applied. European Organization for Research and Treatment of Cancer\/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group definitions were adapted to categorize IFI in a broad patient population. Linear regression was used to model variation in incidence over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 3374 IFI episodes occurred in 3154 patients. The mean incidence was 27.2 cases\/100 000 patients per year, and there was a mean annual increase of 0.24 cases\/100 000 patients (P = .21). Candidiasis was the most common (55%). Dimorphic fungi, primarily Coccidioides spp., comprised 25.1% of cases, followed by Aspergillus spp. (8.9%). The median age was 55 years, and pediatric cases accounted for 13%; 26.1% of patients were on immunosuppression, 14.9% had autoimmunity or immunodeficiency, 13.3% had active malignancy, and 5.9% were transplant recipients. Lymphopenia preceded IFI in 22.1% of patients. Hospital admission occurred in 76.2%. The median length of stay was 16 days. All-cause mortality was 17.0% at 42 days and 28.8% at 1 year. Forty-two-day mortality was highest in Aspergillus spp. (27.5%), 20.5% for Candida, and lowest for dimorphic fungi (7.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this population, IFI was not uncommon, affected a broad spectrum of patients, and was associated with high crude mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofy187","type":"journal-article","created":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T01:39:33Z","timestamp":1533001173000},"source":"Crossref","is-referenced-by-count":164,"title":["Epidemiology and Clinical Features of Invasive Fungal Infection in a US Health Care Network"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1799-3315","authenticated-orcid":false,"given":"Brandon J","family":"Webb","sequence":"first","affiliation":[{"name":"Division of Infectious Disease, Intermountain Healthcare, Salt Lake City, Utah"},{"name":"Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Care Transformation, Intermountain Healthcare, Salt Lake City, Utah"},{"name":"Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Rea","sequence":"additional","affiliation":[{"name":"Care Transformation, Intermountain Healthcare, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Kaufusi","sequence":"additional","affiliation":[{"name":"Care Transformation, Intermountain Healthcare, Salt Lake City, Utah"},{"name":"Innovations and Business Development, Intermountain Healthcare, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E","family":"Goodman","sequence":"additional","affiliation":[{"name":"Care Transformation, Intermountain Healthcare, Salt Lake City, Utah"},{"name":"Innovations and Business Development, Intermountain Healthcare, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Spalding","sequence":"additional","affiliation":[{"name":"Astellas Pharma Global Development, Inc., Northbrook, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,7,31]]},"reference":[{"key":"2020081004285699900_CIT0001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/10408410903241444","article-title":"Epidemiology of invasive mycoses in North America","volume":"36","author":"Pfaller","year":"2010","journal-title":"Crit Rev Microbiol"},{"key":"2020081004285699900_CIT0002","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jhin.2003.08.012","article-title":"The global epidemiology of invasive Candida infections\u2014is the tide turning","volume":"55","author":"Hobson","year":"2003","journal-title":"J Hosp Infect"},{"key":"2020081004285699900_CIT0003","author":"Denning"},{"key":"2020081004285699900_CIT0004","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s10096-013-1944-3","article-title":"Clinical and economic burden of invasive fungal diseases in Europe: focus on pre-emptive and empirical treatment of Aspergillus and Candida species","volume":"33","author":"Drgona","year":"2014","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2020081004285699900_CIT0005","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/978-1-4939-6515-1_2","article-title":"The changing epidemiology of invasive fungal infections","volume":"1508","author":"Enoch","year":"2017","journal-title":"Methods Mol Biol"},{"key":"2020081004285699900_CIT0006","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/978-1-4419-6640-7_2","article-title":"Epidemiology of systemic fungal diseases: an overview","volume-title":"Essentials of Clinical Mycology. 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