January 07, 2020
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Smoking increases risk for invasive fungal disease

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The risk for invasive fungal disease is higher among smokers, according to data from a recent study, leading researchers to suggest that strategies to end smoking be implemented, particularly among those already at increased risk for invasive fungal disease.

Invasive fungal disease (IFD) is a major cause of morbidity and mortality in immunocompromised hosts,” Annabelle Pourbaix, of the Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Paris, and colleagues wrote. “The general population may be at risk for IFD as well, as a result of specific environmental exposures, such as climate and agricultural profession, and lifestyle habits, such as smoking. Several studies have assessed the association between smoking and infection. Smoking increases the risk for bacterial pneumonia and meningitis and second-hand smoke exposure is associated with increased risk for childhood invasive meningococcal disease.”

Pourbaix and colleagues performed a systematic review and meta-analysis that included 25 studies collected from MEDLINE and Web of Science published through September 2018 to investigate the correlation between smoking and risk for IFD.

Results of the analysis showed that there was a greater risk for IFD among smokers (RR = 1.41; 95% CI, 1.09-1.81). The risk for IFD was higher among participants in the retrospective studies compared with those in the prospective studies (RR = 1.93 [95% CI, 1.28-2.92] vs. RR = 1.02 [95% CI, 0.78-1.34]), as well as studies that included multivariate adjustments compared to studies with univariate analysis (RR = 2.15 [95% CI, 1.27-3.64] vs. RR = 1.15 [95% CI, 0.88-1.51]) and in studies published after 2002 (RR = 2.08 [95% CI, 1.37-3.15] vs. RR = 0.95 [95% CI, 0.75-1.22]).

“This review and meta-analysis showed an increased risk for IFD among smokers, with a stable association across a variety of clinical subgroups,” the authors concluded. “This provides new evidence supporting the implementation of smoking cessation strategies, including tobacco, marijuana, opium and crack cocaine, especially in patients with HIV and patients with hematological malignancies who are already at higher risk for IFD.” – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.