Adam, Kai-Manuel; Osthoff, Michael; Lamoth, Frédéric; Conen, Anna; Erard, Véronique; Boggian, Katia; Schreiber, Peter W; Zimmerli, Stefan; Bochud, Pierre-Yves; Neofytos, Dionysios; Fleury, Mapi; Fankhauser, Hans; Goldenberger, Daniel; Mühlethaler, Konrad; Riat, Arnaud; Zbinden, Reinhard; Kronenberg, Andreas; Quiblier, Chantal; Marchetti, Oscar and Khanna, Nina (2021). Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey. Open Forum Infectious Diseases, 8(10), ofab471. Oxford University Press 10.1093/ofid/ofab471
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Background
The increasing incidence of candidemia and emergence of drug-resistant Candida species are major concerns worldwide. Long-term surveillance studies are needed.
Methods
The Fungal Infection Network of Switzerland (FUNGINOS) conducted a 15-year (2004-2018), nationwide, epidemiological study of candidemia. Hospital-based incidence of candidemia, Candida species distribution, antifungal susceptibility, and consumption were stratified in 3 periods (2004-2008, 2009-2013, 2014-2018). Population-based incidence over the period 2009-2018 derived from the Swiss Antibiotic Resistance Surveillance System (ANRESIS).
Results
A total of 2273 Candida blood isolates were studied. Population and hospital-based annual incidence of candidemia increased from 2.96 to 4.20/100 000 inhabitants (P = .022) and 0.86 to 0.99/10 000 patient-days (P = .124), respectively. The proportion of Candida albicans decreased significantly from 60% to 53% (P = .0023), whereas Candida glabrata increased from 18% to 27% (P < .0001). Other non-albicans Candida species remained stable. Candida glabrata bloodstream infections occurred predominantly in the age group 18-40 and above 65 years. A higher proportional increase of C glabrata was recorded in wards (18% to 29%, P < .0001) versus intensive care units (19% to 24%, P = .22). According to Clinical and Laboratory Standards Institute, nonsusceptibility to fluconazole in C albicans was observed in 1% of isolates, and anidulafungin and micafungin nonsusceptibility was observed in 2% of C albicans and C glabrata. Fluconazole consumption, the most frequently used antifungal, remained stable, whereas use of mold-active triazoles and echinocandins increased significantly in the last decade (P < .0001).
Conclusions
Over the 15-year period, the incidence of candidemia increased. A species shift toward C glabrata was recently observed, concurring with increased consumption of mold-active triazoles.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases 04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology |
UniBE Contributor: |
Zimmerli, Stephan, Mühlethaler, Konrad, Kronenberg, Andreas Oskar |
Subjects: |
500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health |
ISSN: |
2328-8957 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Annelies Luginbühl |
Date Deposited: |
29 Oct 2021 09:22 |
Last Modified: |
02 Mar 2023 23:35 |
Publisher DOI: |
10.1093/ofid/ofab471 |
PubMed ID: |
34660836 |
Uncontrolled Keywords: |
antifungals candida candidemia epidemiology resistance |
BORIS DOI: |
10.48350/160293 |
URI: |
https://boris.unibe.ch/id/eprint/160293 |
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