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Insights from ISPOR 2024: Examining the fungus among us

At ISPOR 2024, Cencora showcased vital research on fungal infections, highlighting the WHO's priority pathogens list. Kim Maren Schneider, MA, discussed their findings on hospital data from 2019-2023, revealing that 68.7 percent of hospitalized patients were aged sixty or older. Notably, more men than women were hospitalized, particularly for Cryptococcosis. The research emphasizes the need for increased attention to fungal infections and further studies on healthcare costs and antifungal resistance.

5 questions with Kim Maren Schneider

At ISPOR 2024, Cencora team members presented research posters on a variety of topics in the health economics and outcomes research space. We took the opportunity to chat with them about their work and its potential impact. Here, Kim Maren Schneider, MA, Associate Director, EU Real World Evidence at Cencora answers questions about the poster, “The last of fungUs? Recent developments in fungal infections in the German hospital setting.” Kim-Sarah Krinke, PhD; Janina Röhrkaste, MSc; Christian Jacob, PhD; Sebastian Braun, PhD served as co-authors.

*Available in English only

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What has inspired this research?

In 2022, the World Health Organization (WHO) released the first fungal priority pathogens list, which systematically prioritizes fungal pathogens, since invasive fungal diseases are rising. Due to coding limitations preventing exact species identification of fungal pathogens, our assessment focused on the three fungal genus classifications from the WHO critical priority group (Cryptococcus, Candida, Aspergillus). Particularly among immunocompromised populations, fungal infections can lead to severe outcomes such as chronic illnesses or even death.

However, fungal infections receive limited attention and resources compared to other global public health topics, leading to a lack of data on disease distribution and antifungal resistance patterns. As a trained public health specialist, it is also personally important to me to raise awareness for such lesser-known public health threats.

Was there a hypothesis that was confirmed through the research?

The study was exploratory in nature; therefore, no hypothesis was tested. We analysed German hospital data from 2019-2023 using data from the Institute for the Hospital Remuneration System.

What are the key takeaways from your research?

During the period we analysed, 39,199 patients were hospitalized in Germany due to infections from critical priority pathogens. A majority of those patients—68.7 percent— were 60-years-old or older. However, looking at fungal pathogens separately, patients diagnosed with Cryptococcus were mostly younger than 60 years of age (69.0%).

Two out of three fungal pathogens from the critical priority list—Cryptococcus and Aspergillus –are showing to become more prevalent from 2019 to 2023 among hospitalizations with these three fungal pathogens.

Another interesting takeaway is that some patients presented with more than one antifungal resistance.

Was there anything in the research that was surprising, that you didn't expect, that you found out?

We did not expect that more men than women were hospitalized with fungal infections which required treatment in the inpatient setting. This split was most pronounced in Cryptococcosis, which had 68 percent/32 percent male versus female patient diagnoses.

What are the next steps from this research?

Further observation and research are necessary to estimate the burden and future risks of invasive fungal diseases. A desirable next step would be to look at healthcare resource use and costs associated with fungal infections with Germany. It will be important to continue to monitor the distribution of fungal infections and antifungal resistance so public health authorities can make informed decisions on preventive measurements.