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Observational Study
. 2021 Dec;10(1):450-460.
doi: 10.1080/22221751.2021.1894902.

Trends of pulmonary fungal infections from 2013 to 2019: an AI-based real-world observational study in Guangzhou, China

Zhengtu Li  1 , Yongming Li  1 , Yijun Chen  1 , Jing Li  2 , Shaoqiang Li  1 , Chenglong Li  2 , Ye Lin  1 , Wenhua Jian  1 , Jingrong Shi  2 , Yangqing Zhan  1 , Jing Cheng  1 , Jingping Zheng  1 , Nanshan Zhong  1 , Feng Ye  1
Affiliations
Observational Study

Trends of pulmonary fungal infections from 2013 to 2019: an AI-based real-world observational study in Guangzhou, China

Zhengtu Li et al. Emerg Microbes Infect. 2021 Dec.

Abstract

Recently, the prevalence trend of pulmonary fungal infection (PFI) has rapidly increased. Changes in the risk factors for, distributions of underlying diseases associated with and clinical characteristics of some individual PFIs have been reported in the past decade. However, data regarding PFIs remain uncertain. This study reports the epidemiological characteristics and trends of PFIs over time in recent years. We applied an automated natural language processing (NLP) system to extract clinically relevant information from the electronic health records (EHRs) of PFI patients at the First Affiliated Hospital of Guangzhou Medical University. Then, a trend analysis was performed. From January 1, 2013, to December 31, 2019, 40,504 inpatients and 219,414 outpatients with respiratory diseases were screened, in which 1368 inpatients and 1313 outpatients with PFI were identified. These patients were from throughout the country, but most patients were from southern China. Upward trends in PFIs were observed in both hospitalized patients and outpatients (P<0.05). The stratification by age showed that the incidence of hospitalized patients aged 14-30 years exhibited the most obvious upward trend, increasing from 9.5 per 1000 patients in 2013 to 88.3 per 1000 patients in 2019. Aspergillosis (56.69%) was the most common PFI, but notably, the incidence rates of Talaromyces marneffei, which used to be considered uncommon, exhibited the most rapid increases. In younger PFI patients, the incidence and trend of PFIs have increased. Infection by previously uncommon pathogens has also gradually increased. Increased attention should be paid to young PFI patients and uncommon PFI pathogen infections.

Keywords: Epidemiology; artificial intelligence; incidence; pulmonary fungal infection; trends.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Study profile. *The total number of PFI patients was calculated by the sum of the annual numbers. #The total number of patients (excluding the same ones in different years).
Figure 2.
Figure 2.
Data processing. Data production process (A), Data standardization process (B).
Figure 3.
Figure 3.
Distribution of PFI patients and trends of the incidence of PFI patients by age. Distribution of patients in this study (A), incidence of all PFI patients (B), incidence of inpatients in different age groups (C), percentage of PFI inpatients (D), incidence of PFI outpatients (E), and percentage of PFI inpatients in the <30 age group and >30 age group (F).
Figure 4.
Figure 4.
Trends of the incidence of PFI patients by pathogens. Incidence of all (A) and less uncommon (B) pathogens, and percentage of all pathogens (C).
Figure 5.
Figure 5.
Trends of the incidence of PFI patients by underlying diseases. Incidence of underlying diseases in PFIs patients (A), percentages of underlying diseases (B), and the association between PFI types, comorbidity and clinical information (C).
See this image and copyright information in PMC

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