Biotechnology and Bioprocess Engineering 2019; 24(3): 436-444  
Invasive Fungal Infections and Their Epidemiology: Measures in the Clinical Scenario
Vivek K. Bajpai1,, Imran Khan2, Shruti Shukla1, Pradeep Kumar3, Irfan A. Rather4, Yong-Ha Park4, Yun Suk Huh2,*, and Young-Kyu Han1,*
1Department of Energy and Materials Engineering, Dongguk University-Seoul, Seoul 04620, Korea
2Department of Biological Engineering, Biohybrid Systems Research Center (BSRC), Inha University, Incheon 22212, Korea
3Department of Forestry, North Eastern Regional Institute of Science and Technology (Deemed University), Nirjuli 791109, Arunachal Pradesh, India
4Department of Applied Microbiology and Biotechnology, Yeungnam University, Gyeongsan 38541, Korea
Correspondence to: Young-Kyu Han*
Tel: +82-2-2260-4975; Fax: +82-2-2268-8550
E-mail: ykenergy@dongguk.edu

Yun Suk Huh*
Tel: +82-32860-9177; Fax: +82-32-872-4046
E-mail: yunsuk.huh@inha.ac.kr

Yong-Ha Park*
Tel: +82-53-810-3055; Fax: +82-2-566-0652
E-mail: peter@ynu.ac.kryunsuk.huh@inha.ac.kr
Received: December 10, 2018; Revised: February 14, 2019; Accepted: February 14, 2019; Published online: June 30, 2019.
© The Korean Society for Biotechnology and Bioengineering. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Fungi are increasingly recognized as major clinical pathogens in critically ill patients. Emerging groups of fungal pathogens such as Candida and Cryptococcus spp. are most frequently isolated from clinical setup, including filamentous fungi. Assessment of risk factors of these infections such as hospital-acquired fungal infection and environmental factors, including changes in medical practices and epidemiology as well as fungal infection mediated immunomodulation have provided important therapeutic options in the diagnosis of the fungal infections for clinicians. This review aims to furnish information on the factors affecting invasive fungal infections in a clinical scenario, especially for immunocompromised patients. A review of the recently published literature via PubMed, Elsevier and Medline database was performed. Relevant invasive fungal diseases and their worldwide cases were reviewed. Data on the immune response to the fungal infections in terms of release of anti-fungal effectors have been provided. Information on the anti-fungal mechanistic action via upregulation of immunity through predominant cytokines has been summarized, as well as factors affecting disease scenario of invasive fungal infections in clinical practices. The epidemiology and clinical features of fungal infections have also been reviewed.
Keywords: Invasive fungal pathogens; infection; human diseases; diagnosis; immunomodulation


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