Epidemiology of cutaneous and systemic fungal infections in adult patients on maintenance haemodialysis. Two main types of fungal infections in patients on dialysis can be distinguished: superficial infections in chronic wounds of different sites and invasive infections, mainly occurring during extracorporeal dialysis treatment. We report the results of a retrospective study on a total of 5,828 dialysis patients (aged between 13 and 83 years) observed between January 2000 and January 2002, and selected for investigation by the mycological analysis of nasal swabs. The study aimed at identifying the prevalence and the characteristics of each infection type with a special emphasis on the use of prophylactic antibiotics, and their relationship with the infection rate. The mean prevalence of these infections was 6.8%; their presence was dependent on the location and patient status (3.1% in new patients, 3.9% in already treated patients, and 9.1% in treated patients). The most common fungi were Aspergillus spp., Cryptococcus spp., and yeasts. Fungal infections occurred more frequently during treatment and after a longer dialysis period (greater than 120 months) than during the dialysis period (p < 0.0001), and in diabetics than in non-diabetics (p < 0.005). Prophylaxis, even if applied in 2,267 patients, did not prevent fungal infection, but was linked to a reduction in the prevalence of yeasts only (p < 0.05). However, the total number of infections was significantly reduced. These data suggest that even using prophylaxis, fungal infections are a problem in dialysis patients, but their incidence can be controlled, especially by restricting the duration of treatment and the use of systemic prophylactic therapy.