Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
European Journal of Clinical Microbiology & Infectious Diseases
Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases 1/2010

01.01.2010 | Review

Mycoses in the elderly

verfasst von: H. Hof

Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases | Ausgabe 1/2010

Einloggen, um Zugang zu erhalten

Abstract

Infections with dermatophytes are more prevalent in the elderly than in non-elderly adults; risk factors include local trophic disturbances, underlying diseases such as diabetes and a reduced oxygen supply due to diminished blood circulation. Vaginal mycoses are seldom found. In systemic yeast infections in patients of advanced age, Candida glabrata plays a relatively important role. The dimorphic fungus Coccidioides immitis is more prevalent in the elderly in endemic areas. Although there is no higher susceptibility to moulds in this age group, there are certain situations increasing the risk. The manifestations and symptoms of infection often differ from those of younger patients, which may hamper diagnosis. Deficits in organ function may influence the antifungal drug therapy. Preventive measures such as altering the social environment, avoiding malnutrition, as well as efforts to retard immunosenescence and to improve hygiene are important.
Literatur
1.
2.
Htwe TH, Mushtaq A, Robinson SB et al (2007) Infection in the elderly. Infect Dis Clinics North Am 21:711–743CrossRef
3.
Garibaldi RA (1999) Residential care and the elderly: the burden of infection. J Hosp Infect 43(Suppl):S9–S18CrossRefPubMed
4.
Hornstein OP (2002) Hautkrankheiten und Hautpflege im Alter. Wissenschaftliche Verlagsgesellschaft, Stuttgart
5.
Grove GL (1989) Physiologic changes in older skin. Clin Geriatr Med 5:115–125PubMed
6.
Harris NR, Rumbaut RE (2001) Age-related responses of the microcirculation to ischemia-reperfusion and inflammation. Pathophysiology 8:1–10CrossRefPubMed
7.
Castle SC, Uyemura K, Makinodan T (2007) Impaired immunity and increased risk of infections in older adults: impact of chronic disease on immunosenescence. In: Yoshikawa TT, Ouslander JG (eds) Infection management for geriatrics in long-term care facilities, 2nd edn. Informa Healthcare, New York, London, pp 49–70
8.
Yalçin B, Tamer E, Toy GG et al (2006) The prevalence of skin diseases in the elderly: analysis of 4099 geriatric patients. Int J Dermatol 45:672–676CrossRefPubMed
9.
Kılıç A, Gül Ü, Aslan E et al (2008) Dermatological findings in the senior population of nursing homes in Turkey. Arch Gerontol Geriatr 47:93–98CrossRefPubMed
10.
Piérard G (2001) Onychomycosis and other superficial fungal infections of the foot in the elderly: a pan-European survey. Dermatology 202:220–224CrossRefPubMed
11.
Mügge C, Haustein U-F, Nenoff P (2006) Causative agents of onychomycosis—a retrospective study. J Dtsch Dermatol Ges 4:218–228CrossRefPubMed
12.
13.
Seebacher C, Abeck D, Brasch J et al (2006) Candidiasis of the skin. J Dtsch Dermatol Ges 4:591–596CrossRefPubMed
14.
15.
16.
17.
Seebacher C, Korting HC, Abeck D et al (2005) Tinea der freien Haut. J Dtsch Dermatol Ges 3:921–926CrossRef
18.
Martin ES, Elewski BE (2002) Cutaneous fungal infections in the elderly. Clin Geriatr Med 18:59–75CrossRefPubMed
19.
Ventolini G, Baggish MS (2005) Post-menopausal recurrent vaginal candidiasis: effect of hysterectomy on response to treatment, type of colonization and recurrence rates post-treatment. Maturitas 51:294–298CrossRefPubMed
20.
Klein NC, Cunha BA (2001) Skin and soft tissue infections. In: Yoshikawa TT, Norman DC (eds) Infectious diseases in the aging. Humana, Totowa, NJ, pp 139–145
21.
Dan M, Segal R, Marder V et al (2006) Candida colonization of the vagina in elderly residents of a long-term-care hospital. Eur J Clin Microbiol Infect Dis 25:394–396CrossRefPubMed
22.
Mangram AJ, Horan TC, Pearson ML et al (1999) Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 20:250–278CrossRefPubMed
23.
Anderson DJ, Kaye KS (2007) Skin and soft tissue infections in older adults. Clin Geriatr Med 23:595–613CrossRefPubMed
24.
Faergemann J, Aly R, Maibach HI (1983) Quantitative variations in distribution of Pityrosporum orbiculare on clinically normal skin. Acta Derm Venereol 63:346–348PubMed
25.
Bowman J, Panizza B, Gandhi M (2007) Sphenoid sinus fungal balls. Ann Otol Rhinol Laryngol 116:514–519PubMed
26.
Almståhl A, Wikström M (2005) Microflora in oral ecosystems in subjects with hyposalivation due to medicines or of unknown origin. Oral Health Prev Dent 3:67–76PubMed
27.
Zaremba ML, Daniluk T, Rozkiewicz D et al (2006) Incidence rate of Candida species in the oral cavity of middle-aged and elderly subjects. Adv Med Sci 51(Suppl 1):233–236PubMed
28.
Kanli A, Demirel F, Sezgin Y (2005) Oral candidosis, denture cleanliness and hygiene habits in an elderly population. Aging Clin Exp Res 17:502–507PubMed
29.
Fanello S, Bouchara JP, Sauteron M et al (2006) Predictive value of oral colonization by Candida yeasts for the onset of a nosocomial infection in elderly hospitalized patients. J Med Microbiol 55:223–228CrossRefPubMed
30.
Reinel D, Plettenberg A, Seebacher C et al (2004) Oral candidiasis. J Dtsch Dermatol Ges 2:874–876CrossRefPubMed
31.
Wood GC, Mueller EW, Croce MA et al (2006) Candida sp. isolated from bronchoalveolar lavage: clinical significance in critically ill trauma patients. Intensive Care Med 32:599–603CrossRefPubMed
32.
Bartosch S, Woodmansey EJ, Paterson JC et al (2005) Microbiological effects of consuming a synbiotic containing Bifidobacterium bifidum, Bifidobacterium lactis, and oligofructose in elderly persons, determined by real-time polymerase chain reaction and counting of viable bacteria. Clin Infect Dis 40:28–37CrossRefPubMed
33.
Buddington KK, Donahoo JB, Buddington RK (2002) Dietary oligofructose and inulin protect mice from enteric and systemic pathogens and tumor inducers. J Nutr 132:472–477PubMed
34.
Samonis G, Gikas A, Toloudis P et al (1994) Prospective study of the impact of broad-spectrum antibiotics on the yeast flora of the human gut. Eur J Clin Microbiol Infect Dis 13:665–667CrossRefPubMed
35.
Gedek BR (1991) Regulierung der Darmflora über die Nahrung. Zentralbl Hyg Umweltmed 191:277–301PubMed
36.
Hof H (1995) Pilze im Darm. Was nun? Med Welt 46:219–221
37.
Bueno DJ, Casale CH, Pizzolitto RP et al (2007) Physical adsorption of aflatoxin B1 by lactic acid bacteria and Saccharomyces cerevisiae: a theoretical model. J Food Prot 70:2148–2154PubMed
38.
Shetty PH, Hald B, Jespersen L (2007) Surface binding of aflatoxin B1 by Saccharomyces cerevisiae strains with potential decontaminating abilities in indigenous fermented foods. Int J Food Microbiol 113:41–46CrossRefPubMed
39.
Thompson I (2008) Clostridium difficile-associated disease: update and focus on non-antibiotic strategies. Age Ageing 37:14–18CrossRefPubMed
40.
Boyle RJ, Robins-Browne RM, Tang ML (2006) Probiotic use in clinical practice: what are the risks? Am J Clin Nutr 83:1256–1264PubMed
41.
Cherifi S, Robberecht J, Miendje Y (2004) Saccharomyces cerevisiae fungemia in an elderly patient with Clostridium difficile colitis. Acta Clin Belg 59:223–224PubMed
42.
Segal E, Soroka A, Schechter A (1984) Correlative relationship between adherence of Candida albicans to human vaginal epithelial cells in vitro and candidal vaginitis. Sabouraudia 22:191–200PubMed
43.
Zhao X, Malloy PJ, Ardies CM et al (1995) Oestrogen-binding protein in Candida albicans: antibody development and cellular localization by electron immunocytochemistry. Microbiology 141:2685–2692CrossRefPubMed
44.
Zhang X, Essmann M, Burt ET et al (2000) Estrogen effects on Candida albicans: a potential virulence-regulating mechanism. J Infect Dis 181:1441–1446CrossRefPubMed
45.
46.
Kauffman CA, Hedderwick SA (2007) Fungal infections. In: Yoshikawa TT, Ouslander JG (eds) Infection management for geriatrics in long-term care facilities, 2nd edn. Informa Healthcare, New York, London, pp 445–464
47.
Waugh MA, Evans EG, Nayyar KC et al (1978) Clotrimazole (Canesten) in the treatment of candidal balanitis in men. With incidental observations on diabetic candidal balanoposthitis. Br J Vener Dis 54:184–186PubMed
48.
49.
Emori TG, Banerjee SN, Culver DH et al (1991) Nosocomial infections in elderly patients in the United States, 1986–1990. National Nosocomial Infections Surveillance System. Am J Med 91:289S–293SCrossRefPubMed
50.
Zilberberg MD, Shorr AF, Kollef MH (2008) Secular trends in candidemia-related hospitalization in the United States, 2000–2005. Infect Control Hosp Epidemiol 29:978–980CrossRefPubMed
51.
Castle SC, Uyemura K, Fulop T et al (2007) Host resistance and immune responses in advanced age. Clin Geriatr Med 23:463–479CrossRefPubMed
52.
Mazari L, Lesourd BM (1998) Nutritional influences on immune response in healthy aged persons. Mech Ageing Dev 104:24–40CrossRef
53.
de Jong N, Gibson RS, Thomson CD et al (2001) Selenium and zinc status are suboptimal in a sample of older New Zealand women in a community-based study. J Nutr 131:2677–2684PubMed
54.
Lamagni TL, Evans BG, Shigematsu M et al (2001) Emerging trends in the epidemiology of invasive mycoses in England and Wales (1990–9). Epidemiol Infect 126:397–414CrossRefPubMed
55.
Laupland KB, Gregson DB, Church DL et al (2005) Invasive Candida species infections: a 5 year population-based assessment. J Antimicrob Chemother 56:532–537CrossRefPubMed
56.
Lin PC, Hsiao LT, Poh SB et al (2007) Higher fungal infection rate in elderly patients (more than 80 years old) suffering from diffuse large B cell lymphoma and treated with rituximab plus CHOP. Ann Hematol 86:95–100CrossRefPubMed
57.
Luzzati R, Amalfitano G, Lazzarini L et al (2000) Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital. Eur J Clin Microbiol Infect Dis 19:602–607CrossRefPubMed
58.
Pfaller MA, Diekema DJ (2007) Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 20:133–163CrossRefPubMed
59.
Pappas PG, Rex JH, Lee J et al (2003) A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients. Clin Infect Dis 37:634–643CrossRefPubMed
60.
Pfaller MA, Diekema DJ (2002) Role of sentinel surveillance of candidemia: trends in species distribution and antifungal susceptibility. J Clin Microbiol 40:3551–3557CrossRefPubMed
61.
Pfaller MA, Diekema DJ, Jones RN et al (2002) Trends in antifungal susceptibility of Candida spp. isolated from pediatric and adult patients with bloodstream infections: SENTRY Antimicrobial Surveillance Program, 1997 to 2000. J Clin Microbiol 40:852–856CrossRefPubMed
62.
Diekema DJ, Messer SA, Brueggemann AB et al (2002) Epidemiology of candidemia: 3-year results from the emerging infections and the epidemiology of Iowa organisms study. J Clin Microbiol 40:1298–1302CrossRefPubMed
63.
Malani A, Hmoud J, Chiu L et al (2005) Candida glabrata fungemia: experience in a tertiary care center. Clin Infect Dis 41:975–981CrossRefPubMed
64.
Yang YL, Cheng HH, Lo HJ; Tsary Hospitals (2006) Distribution and antifungal susceptibility of Candida species isolated from different age populations in Taiwan. Med Mycol 44:237–242CrossRefPubMed
65.
Malani AN, Kauffman CA (2007) Candida urinary tract infections: treatment options. Expert Rev Anti Infect Ther 5:277–284CrossRefPubMed
66.
Park BJ, Sigel K, Vaz V et al (2005) An epidemic of coccidioidomycosis in Arizona associated with climatic changes, 1998–2001. J Infect Dis 191:1981–1987CrossRefPubMed
67.
Sunenshine RH, Anderson S, Erhart L et al (2007) Public health surveillance for coccidioidomycosis in Arizona. Ann N Y Acad Sci 1111:96–102CrossRefPubMed
68.
Ampel NM (2007) The complex immunology of human coccidioidomycosis. Ann N Y Acad Sci 1111:245–258CrossRefPubMed
69.
70.
Cornet M, Mallat H, Somme D et al (2003) Fulminant invasive pulmonary aspergillosis in immunocompetent patients—a two-case report. Clin Microbiol Infect 9:1224–1227CrossRefPubMed
71.
Corsini E, Di Paola R, Viviani B et al (2005) Increased carrageenan-induced acute lung inflammation in old rats. Immunology 115:253–261CrossRefPubMed
72.
73.
Lind L, Siegbahn A, Hulthe J, Elmgren A (2008) C-reactive protein and e-selectin levels are related to vasodilation in resistance, but not conductance arteries in the elderly: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Atherosclerosis 199:129–137CrossRefPubMed
74.
Johansen JS, Pedersen AN, Schroll M et al (2008) High serum YKL-40 level in a cohort of octogenarians is associated with increased risk of all-cause mortality. Clin Exp Immunol 151:260–266PubMedCrossRef
75.
Ritz P, Vellas B (2007) Pharmacokinetics and drug toxicity in elderly patients: a case for geriatric core data in clinical trials. J Nutr Health Aging 11:261–264PubMed
76.
Turnheim K (2003) When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol 38:843–853CrossRefPubMed
77.
Lohitnavy M, Lohitnavy O, Thangkeattiyanon O et al (2005) Reduced oral itraconazole bioavailability by antacid suspension. J Clin Pharm Ther 30:201–206CrossRefPubMed
78.
Flammiger A, Maibach H (2006) Drug dosage in the elderly: dermatological drugs. Drugs Aging 23:203–215CrossRefPubMed
79.
Hope WW, Denning DW (2004) Invasive aspergillosis: current and future challenges in diagnosis and therapy. Clin Microb Infect 10:2–4CrossRef
80.
Imhof A, Schaer DJ, Schanz U et al (2006) Neurological adverse events to voriconazole: evidence for therapeutic drug monitoring. Swiss Med Wkly 136:739–742PubMed
81.
Stevens DA, Rendon A, Gaona-Flores V et al (2007) Posaconazole therapy for chronic refractory coccidioidomycosis. Chest 132:952–958CrossRefPubMed
82.
Dowell JA, Knebel W, Ludden T et al (2004) Population pharmacokinetic analysis of anidulafungin, an echinocandin antifungal. J Clin Pharmacol 44:590–598CrossRefPubMed
83.
Nguyen TH, Hoppe-Tichy T, Geiss HK et al (2007) Factors influencing caspofungin plasma concentrations in patients of a surgical intensive care unit. J Antimicrob Chemother 60:100–106CrossRefPubMed
84.
Dinubile MJ, Strohmaier KM, Lupinacci RJ et al (2008) Efficacy and safety of caspofungin therapy in elderly patients with proven or suspected invasive fungal infections. Eur J Clin Microbiol Infect Dis 27:663–670CrossRefPubMed
85.
Beck LH (2000) The aging kidney. Defending a delicate balance of fluid and electrolytes. Geriatrics 55:26–28, 31–32PubMed
86.
87.
Saari TI, Laine K, Bertilsson L et al (2007) Voriconazole and fluconazole increase the exposure to oral diazepam. Eur J Clin Pharmacol 63:941–949CrossRefPubMed
88.
Claesson S, Morrison A, Wertheimer AI et al (1999) Compliance with prescribed drugs: challenges for the elderly population. Pharm World Sci 21:256–259CrossRefPubMed
89.
Fanello S, Bouchara JP, Jousset N et al (2001) Nosocomial Candida albicans acquisition in a geriatric unit: epidemiology and evidence for person-to-person transmission. J Hosp Infect 47:46–52CrossRefPubMed
90.
Chin A, Paw MJ, de Jong N et al (2000) Immunity in frail elderly: a randomized controlled trial of exercise and enriched foods. Med Sci Sports Exerc 32:2005–2011CrossRef
91.
Kagansky N, Berner Y, Koren-Morag N et al (2005) Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. Am J Clin Nutr 82:784–791PubMed
Metadaten
Titel
Mycoses in the elderly
verfasst von
H. Hof
Publikationsdatum
01.01.2010
Verlag
Springer-Verlag
Erschienen in
European Journal of Clinical Microbiology & Infectious Diseases / Ausgabe 1/2010
Print ISSN: 0934-9723
Elektronische ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-009-0822-5

Weitere Artikel der Ausgabe 1/2010

European Journal of Clinical Microbiology & Infectious Diseases 1/2010 Zur Ausgabe

Article

Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia—a five-year retrospective review

Article

Molecular characteristics of pharyngeal and invasive emm3 Streptococcus pyogenes strains from Norway, 1988–2003

Brief Report

Metabolic properties of lactobacilli in women experiencing recurring episodes of bacterial vaginosis with vaginal pH ≥ 5

Article

A mathematical model to study the effect of hepatitis B virus vaccine and antivirus treatment among the Canadian Inuit population

Brief Report

First report on methicillin-resistant Staphylococcus aureus of Spa type T037, Sequence type 239, SCCmec type III/IIIA in Malaysia

Letter to the Editor

Puumala virus reference strain for hantavirus serodiagnosis in France

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise