{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:28:45Z","timestamp":1791401325086,"version":"4.3.3"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Systemic endemic mycoses are systemic fungal infections typically found in tropical and subtropical regions. Their global incidence is rising, including in nonendemic countries, mainly due to migration and international travel. They are a major cause of morbidity and mortality worldwide, especially in immunocompromised patients. This study aimed to analyse incidence trends of endemic mycoses and their presentation in hospitalised patients in Spain from 1997 to 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, observational study drew data from the Spanish National Hospital Discharge Database. We used the diagnostic codes of the 9th and 10th International Classification of Diseases for histoplasmosis, coccidioidomycosis, paracoccidioidomycosis and talaromycosis, retrieving systemic endemic mycoses cases from the national public registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the study period, 646 cases of histoplasmosis, 138 of coccidioidomycosis, 47 of paracoccidioidomycosis and 24 talaromycosis were reported, with a rising number of cases annually, driven mainly by an increase in histoplasmosis. A segmented linear regression predictive model with a 10\u2010year forecast showed a steady increase, reaching 128 hospitalisations (95% confidence interval [CI] 87\u2013168) in Spain in 2031. Overall, in\u2010hospital mortality was 10.9%, higher in histoplasmosis (11.3%) and coccidioidomycosis (10.9%) and independently associated with immunosuppression for both histoplasmosis (adjusted odds ratio [aOR] 3.28, 95% CI 1.72\u20136.24; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and coccidioidomycosis (aOR 4.05, 95% CI 1.22\u201313.44; <jats:italic>p<\/jats:italic>\u2009=\u20090.022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hospitalisations for systemic endemic mycoses, especially histoplasmosis, are on the rise in Spain. Mortality is significant and primarily associated with immunosuppression. This trend is expected to continue in the coming years, underscoring the importance of maintaining hospital\u2010based surveillance of endemic mycoses in nonendemic regions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.70021","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T08:25:10Z","timestamp":1737102310000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Imported Systemic Endemic Mycoses in Spain 1997\u20132021: An Analysis of a National Hospital Database"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9125-7706","authenticated-orcid":false,"given":"Jara","family":"Llenas\u2010Garc\u00eda","sequence":"first","affiliation":[{"name":"Vega Baja Hospital  Orihuela Spain"},{"name":"CIBERINFEC Carlos III Health Institute  Madrid Spain"},{"name":"Clinical Medicine Department Miguel Hern\u00e1ndez University  Elche Spain"},{"name":"FISABIO Foundation for the Promotion of Health and Biomedical Research of the Valencian Community  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7341-3785","authenticated-orcid":false,"given":"Roberto","family":"Gonz\u00e1lez Beiro","sequence":"additional","affiliation":[{"name":"International Organization of Migrations  Madrid Spain"},{"name":"Alvaro Cunqueiro Hospital  Vigo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6501-9867","authenticated-orcid":false,"given":"Jos\u00e9\u2010Manuel","family":"Ramos\u2010Rinc\u00f3n","sequence":"additional","affiliation":[{"name":"Clinical Medicine Department Miguel Hern\u00e1ndez University  Elche Spain"},{"name":"Dr. Balmis University General Hospital  Alicante Spain"},{"name":"ISABIAL Institute for Health and Biomedical Research  Alicante 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