Candidemia in Norway (1991 to 2003): Results from a Nationwide Study

Sandven, Per; Bevanger, Lars; Digranes, Asbjørn; Haukland, Hanne H.; Mannsåker, Turid; Gaustad, Peter

doi:10.1128/jcm.00029-06

Cited by 156 publications

(133 citation statements)

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“…The annual incidence of candidemia in Iceland is slightly higher than that observed in most other population-based European studies when the incidence for analogous time intervals is compared. The annual incidence in the Nordic countries of Finland from 2004 to 2007 and Norway from 2000 to 2003 was 2.9 cases/100,000 population; identical incidence has been reported from Canada (10,11,30). However, Denmark seems to be an outlier, with an annual average incidence of 8.6/100,000 from 2004 to 2009 (13).…”

Section: Discussionsupporting

confidence: 52%

“…Two blood culture systems were used: the Difco ESP system (Difco Laboratories, Detroit, MI) until 2001, and the BacT/Alert system (bioMérieux, Marcy l'Etoile, France) from 2002. An episode of candidemia was defined as at least 1 blood culture positive for Candida species, and episodes were considered to be separate if they occurred at least 30 days apart (11) or were caused by different species. When the incident blood culture was obtained within 48 h of hospital admission, the infection episode was defined as community-onset candidemia.…”

Section: Methodsmentioning

confidence: 99%

“…In recent years, several populationbased surveys in the United States, Canada, Europe, and Australia have reported an increasing incidence. In the United States, the incidence of candidemia has ranged from 6.0 to 13.3/100,000 population per year (4)(5)(6), whereas, at the same time, the incidence rates in most European countries have been lower, ranging from 1.9 to 4.8/100,000/year (7)(8)(9)(10)(11)(12). Exceptionally high incidence of candidemia has recently been reported both in Baltimore, 26.2/ 100,000/year (4), and Denmark, 8.6/100,000/year (13).…”

mentioning

confidence: 99%

“…However, significant geographical differences in species distribution exist. The proportion of candidemia caused by C. albicans ranges from 37% in Latin America up to 70% in the Nordic countries (10,11,14). Furthermore, the relative proportions of non-albicans Candida pathogens also vary between the northern and southern parts of the world.…”

mentioning

confidence: 99%

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Nationwide Study of Candidemia, Antifungal Use, and Antifungal Drug Resistance in Iceland, 2000 to 2011

2013

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Candidemia is often a life-threatening infection, with highly variable incidence among countries. We conducted a nationwide study of candidemia in Iceland from 2000 to 2011, in order to determine recent trends in incidence rates, fungal species distribution, antifungal susceptibility patterns, and concurrent antifungal consumption. A total of 208 infection episodes in 199 patients were identified. The average incidence during the 12 years was 5.7 cases/100,000 population/year, which was significantly higher than that from 1990 to 1999 (4.3/100,000/year; P ‫؍‬ 0.02). A significant reduction in the use of blood cultures was noted in the last 3 years of the study, coinciding with the economic crisis in the country (P < 0.001). Age-specific incidence rates were highest among patients at the extremes of age, 20.7/100,000 for <1 year of age and 18.1/100,000 for >60 years, and varied by gender. Age-specific incidence among males >80 years old was 28.6/100,000/year, and it was 8.3/100,000/year for females in this age group (P ‫؍‬ 0.028). The 30-day survival rate among adult patients remained unchanged compared to that from 1990 to 1999 (70.4% versus 69.5%, P ‫؍‬ 0.97). Candida albicans was the predominant species (56%), followed by C. glabrata (16%) and C. tropicalis (13%). The species distribution remained stable compared to that from previous decades. Fluconazole use increased 2.4-fold from 2000 to 2011, with no increase in resistance. In summary, the incidence of candidemia in Iceland has continued to increase but may have reached a steady state, and no increase in antifungal drug resistance has been noted. Decreased use of blood cultures toward the end of the study may have influenced detection rates.

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Section: Discussionsupporting

confidence: 52%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Nationwide Study of Candidemia, Antifungal Use, and Antifungal Drug Resistance in Iceland, 2000 to 2011

2013

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“…Candidemia is defined as at least 1 blood culture bottle positive for Candida species and other sign of blood stream infection. Episodes were considered separate if they occur 1 month apart or were caused by different species (Chen et al, 2003;Sandven et al, 2006). Candidemia is a life threatening fungal infection associated with mortality rate of 38% and prolongs hospital stay by as much as 30 days (Wey et al, 1998).…”

Section: Introductionmentioning

confidence: 99%