Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey
Author:
Adam Kai-Manuel1, Osthoff Michael12, Lamoth Frédéric34, Conen Anna5, Erard Véronique6, Boggian Katia7, Schreiber Peter W8, Zimmerli Stefan910, Bochud Pierre-Yves3, Neofytos Dionysios11, Fleury Mapi12, Fankhauser Hans13, Goldenberger Daniel14, Mühlethaler Konrad910, Riat Arnaud15, Zbinden Reinhard16, Kronenberg Andreas10, Quiblier Chantal16, Marchetti Oscar317, Khanna Nina12ORCID, Bregenzer Thomas, Conen Anna, Adam Kai-Manuel, Conen Anna, Flückiger Ursula, Khanna Nina, Orasch Christina, Heininger Ulrich, Franciolli Mario, San Giovanni Ospedale, Damonti Lauro, Zimmerli Stefan, Rothen Madeleine, Zellweger Claudine, Rothen Madeleine, Tarr Philipp, Fleisch Felix, Chuard Christian, Erard Véronique, Emonet Stéphane, Garbino Jorge, Neofytos Dionysios, van Delden Christian, Genne Daniel, Bochud Pierre-Yves, Calandra Thierry, Damonti Lauro, Erard Véronique, Lamoth Frédéric, Marchetti Oscar, Orasch Christina, Chave Jean-Philippe, Bois-Cerf Clinique, Cécil Clinique, La Source Clinique, Graber Peter, Monotti Rita, Regionale Ospedale, Bernasconi Enos, Civico Ospedale, Rossi Marco, Krause Martin, Piso Rein-Jan, Bally Frank, Troillet Nicolas, Boggian Katia, Eich Gerhard, Gubler Jacques, Fehr Jan, Imhof Alexander, Ruef Christian, Werner Schreiber Peter, Eich Gerhard, Gubler Jacques, Berger Christoph, Fankhauser Hans, Heinzer Ivo, Goldenberger Daniel, Frei Reno, Hertel Roland, Dolina Marisa, Petrini Orlando, Dubuis Olivier, Mühlethaler Konrad, Graf Suzanne, Risch Martin, Ritzler Eva, Fracheboud Dominique, Riat Arnaud, Rohner Peter, Schrenzel Jacques, Lienhardt Reto, Bille Jacques, Lamoth Frédéric, Andreutti-Zaugg Corinne, Gallusser Alberto, Graf Suzanne, Pfyffer Gaby, Herzog Karin, Schibli Urs, Tissière Lysiane, Bruderer Thomas, Zbinden Reinhard,
Affiliation:
1. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland 2. Department of Clinical Research, University Basel, Basel, Switzerland 3. Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland 4. Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland 5. Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital of Aarau, Aarau, Switzerland 6. Infectious Diseases Service, Department of Medicine, Cantonal Hospital, Fribourg, Switzerland 7. Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital, St. Gallen, Switzerland 8. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland 9. Department of Infectious Diseases, Bern University Hospital, Bern, Switzerland 10. Institute for Infectious Diseases, University of Bern, Bern, Switzerland 11. Infectious Diseases Service, University Hospital and University of Geneva, Geneva, Switzerland 12. Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland 13. Institute of Laboratory Medicine, Cantonal Hospital of Aarau, Aarau, Switzerland 14. Clinical Bacteriology and Mycology, University Hospital of Basel and University of Basel, Basel, Switzerland 15. Division of Laboratory Medicine, Laboratory of Bacteriology, University Hospital of Geneva, Geneva, Switzerland 16. Institute of Medical Microbiology, University of Zürich, Zürich, Switzerland 17. Department of Medicine, Ensemble Hospitalier de la Côte, Morges, Switzerland
Abstract
Abstract
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.
Funder
Schering-Plough Gilead Foundation Merck and Sharp and Dohme Novartis Pfizer Foundation for the Advancement in Medical Microbiology and Infectious Diseases
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Cited by
21 articles.
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