Epidemiology of fungaemia in Sweden: A nationwide retrospective observational survey.

OBJECTIVES: To identify the epidemiology and antifungal susceptibilities of Candida spp. among blood culture isolates to identify the epidemiology and antifungal susceptibilities of Candida spp. among blood culture isolates in Sweden. METHODS: The study was a retrospective, observational nationwide laboratory-based surveillance for fungaemia and fungal meningitis and was conducted from September 2015 to August 2016. RESULTS: In total, 488 Candida blood culture isolates were obtained from 471 patients (58% males). Compared to our previous study, the incidence of candidaemia has increased from 4.2/100 000 (2005-2006) to 4.7/100 000 population/year (2015-2016). The three most common Candida spp. isolated from blood cultures were Candida albicans (54.7%), Candida glabrata (19.7%) and species in the Candida parapsilosis complex (9.4%). Candida resistance to fluconazole was 2% in C. albicans and between 0% and 100%, in non-albicans species other than C. glabrata and C. krusei. Resistance to voriconazole was rare, except for C. glabrata, C. krusei and C. tropicalis. Resistance to anidulafungin was 3.8% while no Candida isolate was resistant to amphotericin B. CONCLUSIONS: We report an overall increase in candidaemia but a minor decrease of C. albicans while C. glabrata and C. parapsilosis remain constant over this 10-year period.

Incidence, microbiology and clinical history of peritonsillar abscesses.

The objective of this study was to describe the incidence and microbiology of peritonsillar abscesses (PTA) and to study the clinical history with special reference to primary care management of these patients. We performed a retrospective study of hospital records to determine the incidence of PTA in 2000-2006, and a prospective study of consecutive PTA patients to study the microbiology of PTA, the clinical history and previous management in primary care of these patients. The incidence of PTA varied between 19 and 37/100,000 per y in the y 2000-2006. In total, 89 patients were included in the prospective study (54M, 35F), with a median age of 22 y (range 13-83 y). The most frequent single bacterial agent found was group A beta- haemolytic Streptococcus (GAS), identified in 18% of throat swabs and 24% of aspirates. The majority of PTA developed within 5 d of onset of sore throat and 54% of patients presented without prior consultation for sore throat. In the studied population the patient that first presented to primary care seems to have been appropriately managed and referred.