Changes in the relative prevalence of candidaemia due to non‐albicans Candida species in adult in‐patients: A systematic review, meta‐analysis and meta‐regression

Abstract

Summary Background Candidaemia remains associated with high mortality and increased costs worldwide. Objective To assess the changes over time in the relative prevalence of non‐albicans candidaemia (NAC). Methods A systematic review, meta‐analysis and meta‐regression were performed. Observational studies investigating the epidemiology of consecutive, non‐selected, candidaemia episodes were included. Two separated analyses were conducted: (a) whole hospital analysis and (b) intensive care unit (ICU) analysis. Results Starting from an initial total of 7726 records, 220 studies fulfilled inclusion criteria. The pooled prevalence of NAC in whole hospital analysis was 49.5% (95% confidence intervals [CI] 48.0‐51.1, I2 93.1%), while the pooled prevalence in ICU analysis was 50.6% (95% CI 46.6‐54.6; I2 86.7%). In meta‐regression, a progressive increase in NAC prevalence was observed in whole hospital analysis, although it explained only a small portion of between‐study variance (estimated yearly prevalence change +0.3%, 95% CI from +0.1% to +0.5%, P = .003; adjusted R2 3.42%) and was observed only in some continents in subgroup analyses. No relevant changes over time were observed in NAC prevalence for ICU studies. Conclusions We registered an increasing trend in the relative prevalence of NAC, which, nonetheless, seems to be limited to some continents and to contribute only minimally to explain the observed differences in NAC prevalence across studies.

Predominance of Candida Glabrata among Non-albicans Candida Species in a 16-Year Study of Candidemia at a Tertiary Care Center in Lebanon

“…Due to the growing number of immunocompromised patients and critically ill patients, as well as the increasing use of invasive devices and antibiotics, the incidence of candidemia has been increasing around the world [2,6]. Particularly, there has been a rise in the incidence of non-albicans candidemia (NAC) [7].…”

Characteristics of Extracellular Vesicles Released by the Pathogenic Yeast-Like Fungi Candida glabrata, Candida parapsilosis and Candida tropicalis

“…The burden of severe fungal infections worldwide and the related threats to the constantly increasing number of individuals susceptible to such infections, requires a comprehensive investigation of their pathogenesis. Although the best-known and the most common species of this genus causing infections in humans is still C. albicans, the global epidemiology of candidiasis is currently changing and other species, collectively called non-albicans Candida (NAC) species and primarily including C. glabrata, C. parapsilosis and C. tropicalis, are increasingly emerging as etiological agents of systemic diseases [8][9][10]. The biology and the virulence mechanisms of NAC species are still not thoroughly understood, which is a particularly important and pressing issue if one takes into account the growing clinical significance of these fungi and the increasing number of serious infections they cause [1].…”

Anti-Candida Activity of Essential Oils from Lamiaceae Plants from the Mediterranean Area and the Middle East

“…Overall, Candida spp. are one of the primary causes of catheter-associated bloodstream infections in intensive care units of U.S. and European hospitals, and the fourth most common cause of nosocomial bloodstream infection in the USA [ 1 , 2 ]. These severe infections are associated with high mortality rates that are difficult to ascertain, as many patients who acquire candidemia have an underlying medical condition.…”