Changing epidemiology of candidaemia in Australia

Chapman, Belinda; Slavin, Monica A; Marriott, Debbie; Halliday, Catriona; Kidd, Sarah; Arthur, Ian; Bak, Narin; Heath, Christopher H.; Kennedy, Karina; Morrissey, C. Orla; Sorrell, Tania C.; Hal, Sebastian Van; Keighley, Caitlin; Goeman, Emma; Underwood, Neil; Hajkowicz, Krispin; Hofmeyr, Ann; Leung, M.; Macesic, Nenad; Botes, Jeannie; Blyth, Christopher C; Cooley, Louise; George, C R Robert; Kalukottege, Pankaja; Kesson, Alison; McMullan, Brendan; Baird, Robert W.; Robson, Jennifer; Korman, Tony M.; Pendle, Stella; Weeks, Kerry; Liu, Eunice; Cheong, Elaine; Chen, Sharon

doi:10.1093/jac/dkw422

Cited by 112 publications

(136 citation statements)

References 20 publications

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“…Epidemiology of Candida infections is changing worldwide with increasing prevalence of non‐ albicans species . Of the Candida identified in our study, 70% were non‐ albicans , with C. parapsilosis being the most frequently isolated Candida overall.…”

Section: Discussionmentioning

confidence: 72%

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

Bartlett

Cann

Yeoh

et al. 2018

Pediatric Blood & Cancer

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Background A thorough understanding of local and contemporary invasive fungal infection (IFI) epidemiology in immunocompromised children is required to provide a rationale for targeted prevention and treatment strategies. Methods Retrospective data over 10 years from four tertiary pediatric oncology and hematopoietic stem cell transplant (HSCT) units across Australia were analyzed to report demographic, clinical, and mycological characteristics of IFI episodes, and crude IFI prevalence in select oncology/HSCT groups. Kaplan–Meier survival analyses were used to calculate 180‐day overall survival. Results A total of 337 IFI episodes occurred in 320 children, of which 149 (44.2%), 51 (15.1%), and 110 (32.6%) met a modified European Organization for Research and Treatment of Cancer (mEORTC) criteria for proven, probable, and possible IFI, respectively. There were a further 27 (8.0%) that met a “modified possible IFI” criteria. Median age at IFI diagnosis was 8.4 years. Crude mEORTC IFI prevalence in acute lymphoblastic leukemia, acute myeloid leukemia, solid tumor, and allogeneic HSCT cohorts was 10.6%, 28.2%, 4.4%, and 11.7%, respectively. Non‐Aspergillus species represented 48/102 (47.1%) molds identified, and non‐albicans Candida represented 66/93 (71.0%) yeasts identified. There were 56 deaths among 297 children who met mEORTC criteria, with 180‐day overall survival for proven, probable, and possible IFIs of 79.7%, 76.2%, and 84.4%, respectively. Conclusion Non‐Aspergillus molds and non‐albicans Candida contributed substantially to pediatric IFI in our study, with high IFI prevalence in leukemia and allogeneic HSCT cohorts. Inclusion of IFIs outside of European Organization for Research and Treatment of Cancer criteria revealed an IFI burden that would go otherwise unrecognized in published reports.

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Section: Discussionmentioning

confidence: 72%

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

Bartlett

Cann

Yeoh

et al. 2018

Pediatric Blood & Cancer

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“…In Chile, Siri et al observed that C. glabrata was the main NCA species from 2000 to 2006; however, from 2007 to 2013, C. parapsilosis was the predominant NCA species involved in candidemia episodes. An Australian study observed a 1.7‐fold increase in C. glabrata candidemia since 2004 . Additionally, a rise in C. glabrata was reported in Turkey and China .…”

Section: Discussionmentioning

confidence: 99%

“…Candida glabrata is an important agent of candidemia in the USA, and Cleveland et al reported prevalences of 36% for C. albicans , 27% for C. glabrata , 15% for C. parapsilosis and 9% for C. tropicalis . The recent rise in C. glabrata candidemia has been attributed to fluconazole prophylaxis, once this species present intrinsic less susceptibility to this antifungal agent . A study conducted in Argentina, Brazil, Chile, Colombia, Ecuador, Honduras and Venezuela reported that Brazil showed the highest prevalence of C. glabrata candidemia .…”

Section: Discussionmentioning

confidence: 99%

Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Canela

Cardoso

Vitali

et al. 2017

Mycoses

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SummaryCandida spp. are responsible for 80% of all systemic fungal infections and are associated with high mortality rates. This study characterised 79 bloodstream isolates of C. albicans, C. glabrata, C. orthopsilosis, C. parapsilosis and C. tropicalis from patients in a Brazilian hospital. The susceptibility to amphotericin B, caspofungin, fluconazole and voriconazole was determined; virulence factor production was assessed based on haemolysin, phospholipase and proteinase activities, and the patients' clinical characteristics were analysed. C. albicans was the predominant species (44%), followed by C. glabrata (19%), C. tropicalis (19%), C. parapsilosis (14%) and C. orthopsilosis (4%). The candidemia incidence was 1.52 per 1000 admissions, and the crude mortality rate was 52%. One C. albicans isolate was resistant to fluconazole and voriconazole. Moreover, 20.2%, 2.5% and 3.8% of the isolates exhibited dosedependent susceptibility to fluconazole, voriconazole and caspofungin, respectively.In conclusion, although the C. glabrata incidence was higher than that usually described in Brazil, its increase was previously observed in studies conducted worldwide. Furthermore, the azole resistance of the C. albicans isolate could be due to previous exposure to these antifungals. These results highlight the importance of epidemiological studies and will facilitate an improved understanding of candidemia in the studied hospital. K E Y W O R D Santifungal susceptibility, Candida spp., candidemia, virulence factors

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“…Among the various approaches, PCR‐RFLP‐based methods are notable due to their versatility, and the protocol proposed by Tavanti based on the amplification of the SADH gene and subsequent Ban I digestion is the most widely used since its description 7,33 . The hypothesis of a time‐ or geographically dependent epidemiological shift could be drawn from the data, but interestingly, some recent studies report similar frequencies of isolation that appear to be influenced by the method chosen for the identification 11,37‐39 …”

Section: Discussionmentioning

confidence: 99%

Utility of two PCR‐RFLP‐based techniques for identification of Candida parapsilosis complex blood isolates

Marcos‐Arias

Mateo

Jurado‐Martín

et al. 2020

Mycoses

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Background: Candida parapsilosis is the second or third most frequently isolatedCandida species related to nosocomial infections, even overtaking Candida albicans in some hospitals. C. parapsilosis constitutes a complex of closely related species:Candida parapsilosis sensu stricto, Candida orthopsilosis and Candida metapsilosis.Accurate detection of these species is of importance, as the incidence of C. orthopsilosis has been reported to surpass that of Candida krusei.Objective: To evaluate the diagnostic utility of two PCR-RFLP methods targeting the SADH and FKS1 genes and to determine the prevalence of cryptic species in 96 bloodstream isolates of C. parapsilosis from 93 patients. Methods:Restriction patterns of the SADH and FKS1 genes were analysed, and sequencing of the D1/D2 regions of the ribosomal RNA was used to evaluate the reliability of both PCR-RFLP methods.Results: In our study, 77 C. parapsilosis sensu stricto, 13 C. orthopsilosis and five C. metapsilosis were identified by sequencing. Both PCR-RFLP methods demonstrated strong agreement with D1/D2 sequencing in the identification of C. parapsilosis and C. orthopsilosis, while both methods were unable to identify the C. metapsilosis isolates. Moreover, unexpected restriction patterns were observed for two isolates on SADH PCR-RFLP and for four isolates on FKS1 PCR-RFLP. Mixed bloodstream infections of C. parapsilosis sensu stricto and C. orthopsilosis were detected for three patients, for which differential growth characteristics were observed. Conclusion:The molecular method chosen for identification could have an impact on determination of the real prevalence of C. metapsilosis in candidaemia, and mixed fungaemias can remain undetected. K E Y W O R D SCandida metapsilosis, Candida orthopsilosis, D1/D2 large subunit sequencing, PCR-RFLP, SADH and FKS1 genes

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Changing epidemiology of candidaemia in Australia

Abstract: We report an almost 1.7-fold proportional increase in C. glabrata candidaemia (26.7% versus 16% in 2004) in Australia. Antifungal resistance was generally uncommon, but azole resistance (16.7% of isolates) amongst C. tropicalis may be emerging.

Cited by 112 publications

References 20 publications

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Utility of two PCR‐RFLP‐based techniques for identification of Candida parapsilosis complex blood isolates

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