Changing epidemiology of candidaemia in Australia.
J Antimicrob Chemother
; 72(4): 1103-1108, 2017 04 01.
Article
en En
| MEDLINE
| ID: mdl-28364558
ABSTRACT
Objectives:
Knowledge of contemporary epidemiology of candidaemia is essential. We aimed to identify changes since 2004 in incidence, species epidemiology and antifungal susceptibilities of Candida spp. causing candidaemia in Australia.Methods:
These data were collected from nationwide active laboratory-based surveillance for candidaemia over 1 year (within 2014-2015). Isolate identification was by MALDI-TOF MS supplemented by DNA sequencing. Antifungal susceptibility testing was performed using Sensititre YeastOne™.Results:
A total of 527 candidaemia episodes (yielding 548 isolates) were evaluable. The mean annual incidence was 2.41/105 population. The median patient age was 63 years (56% of cases occurred in males). Of 498 isolates with confirmed species identity, Candida albicans was the most common (44.4%) followed by Candida glabrata complex (26.7%) and Candida parapsilosis complex (16.5%). Uncommon Candida species comprised 25 (5%) isolates. Overall, C. albicans (>99%) and C. parapsilosis (98.8%) were fluconazole susceptible. However, 16.7% (4 of 24) of Candida tropicalis were fluconazole- and voriconazole-resistant and were non-WT to posaconazole. Of C. glabrata isolates, 6.8% were resistant/non-WT to azoles; only one isolate was classed as resistant to caspofungin (MIC of 0.5 mg/L) by CLSI criteria, but was micafungin and anidulafungin susceptible. There was no azole/echinocandin co-resistance.Conclusions:
We report an almost 1.7-fold proportional increase in C. glabrata candidaemia (26.7% versus 16% in 2004) in Australia. Antifungal resistance was generally uncommon, but azole resistance (16.7% of isolates) amongst C. tropicalis may be emerging.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Candida
/
Candidemia
/
Antifúngicos
Tipo de estudio:
Incidence_studies
/
Prognostic_studies
/
Screening_studies
Límite:
Female
/
Humans
/
Male
País/Región como asunto:
Oceania
Idioma:
En
Revista:
J Antimicrob Chemother
Año:
2017
Tipo del documento:
Article
País de afiliación:
Australia