Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey.

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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The increasing incidence of candidemia and emergence of drug-resistant Candida species are major concerns worldwide. Long-term surveillance studies are needed.


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).


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).


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)


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, Stefan; Mühlethaler, Konrad and Kronenberg, Andreas Oskar


500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health




Oxford University Press




Annelies Luginbühl

Date Deposited:

29 Oct 2021 09:22

Last Modified:

29 Oct 2021 09:22

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

antifungals candida candidemia epidemiology resistance




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