Changes in the distribution of colonising and infecting Candida spp. isolates, antifungal drug consumption and susceptibility in a French intensive care unit: A 10‐year study

Abstract

Monitoring fungal ecology and resistance to antifungal agents within intensive care units (ICU) is essential for the management of invasive fungal infections. Therefore, a retrospective descriptive study was carried in the ICU of Nimes University Hospital, France, from 2007 to 2016. As the majority of invasive fungal infections in ICU are caused by Candida species, the study objectives were to describe Candida species distribution, to assess candidaemia incidence and to monitor the antifungal drug susceptibility of Candida isolates and the consumption of antifungal agents. Among the recorded invasive Candida infections (n=244), 43% were intra-abdominal and 22% bloodstream infections. Candida albicans was the most frequent species (55.8%), followed by Candida glabrata (14.1%), Candida tropicalis (10%), Candida parapsilosis (8%) and Candida krusei (5.3%). Candidaemia incidence was 4.49 per 1000 admissions. The mean consumption of antifungal agents was of 170.5 defined daily doses (DDD) for 1000 hospital days (HD) per year. Changes in antifungal drug consumption were observed, with an increased use of echinocandins (from 17.96 DDD/1000 HD in 2007 to 48.76 DDD/1000 HD in 2016), and the total treatment cost tripled during the study period. No significant change in fungal ecology or in the emergence of resistant species was observed; indeed, only 1.1% of isolates presented an unusual resistance to antifungal agents.

Distribution of Candida albicans and non-albicans Candida species isolated in different clinical samples and their in vitro antifungal suscetibity profile in Ethiopia

“…While Candida albicans was the most frequently isolated yeast in the present study, its prevalence was lower than a study conducted in Northwest Ethiopia [16] and higher than a study conducted in central Ethiopia [17]. Candida albicans as the most frequently isolated species was also reported by Sasso et al [30], Mnge et al [31], and Zeng et al [32]. C. parapsilosis as the most frequently isolated yeast was depicted in a study conducted by Sahal and Bilkay [33].…”

Morbidity and mortality of candidaemia in Europe: an epidemiologic meta-analysis

“…Western 15,18,37,46,49,50,55,67,85,92,105,108,110,112,113,125,127,[132][133][134] and four in Eastern Europe (Tables S1-S3). 59,103,109,124 One study comprised a pan-European survey.…”

Dermaseptin-S1 decreasesCandida albicansgrowth, biofilm formation and the expression of hyphal wall protein 1 and aspartic protease genes

“…Furthermore, C. albicans is responsible for a bloodstream infection known as candidemia in vulnerable groups of patients, including those in intensive care units (Sassom et al . ).…”

“…Patients suffering from burns and newborn (especially premature) babies are also subject to C. albicans skin infections (Devrim et al 2017). Furthermore, C. albicans is responsible for a bloodstream infection known as candidemia in vulnerable groups of patients, including those in intensive care units (Sassom et al 2017).…”