Candidemia in Finland, 1995–1999

Abstract

We analyzed laboratory-based surveillance candidemia data from the National Infectious Disease Register in Finland and reviewed cases of candidemia from one tertiary-care hospital from 1995 to 1999. A total of 479 candidemia cases were reported to the Register. The annual incidence rose from 1.7 per 100,000 population in 1995 to 2.2 in 1999. Species other than Candida albicans accounted for 30% of cases without change in the proportion. A total of 79 cases of candidemia were identified at the hospital; the rate varied from 0.03 to 0.05 per 1,000 patient-days by year. Predisposing factors included indwelling catheters (81%), gastrointestinal surgery (27%), hematologic malignancy (25%), other types of surgery (21%), and solid malignancies (20%). Crude 7-day and 30-day case-fatality ratios were 15% and 35%, respectively. The rate of candidemia increased in Finland but is still substantially lower than in the United States. No shift to non–C. albicans species could be detected.

Seminational Surveillance of Fungemia in Denmark: Notably High Rates of Fungemia and Numbers of Isolates with Reduced Azole Susceptibility

“…Sandven et al reported a low and rather constant annual rate of candidemia in Norway from 1991 to 1999 (2.2% of BSI or 2.17 per 100,000 people), whereas Poikonen et al reported annual rates to increase in Finland from 1.7 to 2.2 per 100,000 people from 1995 to 1999 (18,20,21). In this context, our estimated annual rate of 11 per 100,000 people seems very high.…”

“…tribution rather unchanged during the last decade, whereas in Finland, an increase was observed from 1995 to 1999 (18,20,21). There are few data on the epidemiology of fungemia in Denmark.…”

“…Variations in the rate and species distribution between countries and hospital settings are prominent. Thus, fungemia in most European studies accounts for far less than 5% of bloodstream infections (BSI), in contrast to the United States (6 to 8% of BSI), and although C. albicans is the predominant species on both sides of the Atlantic, the percentage varies, being ϳ50% in the United States and Spain, over 56% in a recent European study covering France, Germany, Austria, Spain, Sweden, and the United Kingdom, and ϳ70% in a recent study in Finland (1,5,18,20,21,25). The distribution of non-C. albicans species has changed over time, and the prevalence of C. glabrata especially has been shown in many studies to be on the rise, which is important due to its intrinsic decreased fluconazole susceptibility (4,24,26).…”

Secular Trends in Candidemia-Related Hospitalization in the United States, 2000–2005

“…Other studies from abroad have noted increases in the incidence of hospitalization with candidemia that were similar in magnitude to the increase in our study. 8 Our analysis has multiple limitations. It relied on ICD-9-CM coding to identify candidemia-related hospitalizations, which may have predisposed our case ascertainment to misclassification.…”

Candidaemia in allogeneic stem cell transplant recipients: low risk without fluconazole prophylaxis

“…It should be noted that considerably higher incidences for candidaemia have been reported from US, 7,13 where candidaemia is much more common in hospitalised patients when compared to the situation in Finland. 15,16 In the present series, C. albicans was clearly dominating, probably due to lack of fluconazole prophylaxis. This finding is in a striking contrast with the series reported by Safdar et al 7 where non-albicans strains (C. glabrata, C. krusei, C. parapsilosis) were the causative agents; all patients had received fluconazole prophylaxis.…”