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/dkx047

Cited by 115 publications

(51 citation statements)

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“…In Denmark, an increasing incidence of candidemia was demonstrated during 8 years, reaching 10.1/100,000 inhabitants in 2011 (18). Although increasing incidence rates have also been found elsewhere, the Danish incidence is notably high compared to other reported contemporary nationwide incidence rates of 2.4 to 5.7/100,000 inhabitants (12)(13)(14)(15)(16).…”

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confidence: 71%

“…In general, populationbased studies are less prone to bias, especially when the study base becomes large and representative of entire countries. Nationwide surveillance data are available from Australia, Scotland, Finland, Iceland, Norway, Sweden, and Denmark (DK) (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In Denmark, an increasing incidence of candidemia was demonstrated during 8 years, reaching 10.1/100,000 inhabitants in 2011 (18).…”

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confidence: 99%

“…Besides increasing incidence rates, another common observation is the changing species distribution to non-albicans species and particularly to Candida glabrata in the Northern Hemisphere, Australia, and Taiwan and C. parapsilosis in southern Europe and South America (3,12,13,19,20) at the expense of C. albicans. The increase in C. glabrata levels has been coupled with an increased use of azoles, to which C. glabrata is intrinsically less susceptible (18,21,22).…”

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confidence: 99%

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Update from a 12-Year Nationwide Fungemia Surveillance: Increasing Intrinsic and Acquired Resistance Causes Concern

et al. 2018

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New data from the years 2012 to 2015 from the Danish National Fungemia Surveillance are reported, and epidemiological trends are investigated in a 12-year perspective (2004 to 2015). During 2012 to 2015, 1,900 of 1,939 (98%) fungal bloodstream isolates were included. The average incidence was 8.4/100,000 inhabitants, and this appears to represent a stabilizing trend after the increase to 10.1/100,000 in 2011. The incidence was higher in males than females (10.0 versus 6.8) and in patients above 50 years, and those changes were mainly driven by an increasing incidence among 80-to-89-year-old males (65.3/100,000 in 2014 to 2015). The proportion of isolates decreased from 2004 to 2015 (64.4% to 42.4%) in parallel with a doubling of the proportion of isolates (16.5% to 34.6%, < 0.0001). was more common among females (34.0% versus 30.4% in males). Following an increase in 2004 to 2011, the annual drug use stabilized during the last 2 to 3 years of that time period but remained higher than in other Nordic countries. This was particularly true for the fluconazole and itraconazole use in the primary health care sector, which exceeded the combined national levels of use of these compounds in each of the other Nordic countries. Fluconazole susceptibility decreased (68.5%, 65.2%, and 60.6% in 2004 to 2007, 2008 to 2011, and 2012 to 2015, respectively, < 0.0001), and echinocandin resistance emerged in (0%, 0.6%, and 1.7%, respectively, < 0.001). Amphotericin B susceptibility remained high (98.7%). Among 16 (2.7%) echinocandin-resistant isolates (2012 to 2015), 13 harbored FKS mutations and 5 (31%) were multidrug resistant. The epidemiological changes and the increased incidence of intrinsic and acquired resistance emphasize the importance of continued surveillance and of strengthened focus on antifungal stewardship.

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confidence: 71%

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confidence: 99%

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Update from a 12-Year Nationwide Fungemia Surveillance: Increasing Intrinsic and Acquired Resistance Causes Concern

et al. 2018

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“…19 There is also a striking paucity of mucormycosis, which is in contrast to other international paediatric 10,12 and local adult 26 Epidemiology of Candida infections is changing worldwide with increasing prevalence of non-albicans species. 1,27,28 Of the Candida identified in our study, 70% were non-albicans, with C. parapsilosis being the most frequently isolated Candida overall. The high proportion of C. parapsilosis in children with acute leukemia is in keeping with other international pediatric cohorts, 19 which likely reflects the recognized affinity for this organism for central venous access devices.…”

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confidence: 83%

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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“…8.6/100,000 in Denmark, and 8.1/100,000 cases in Spain, which also has had a 1.88-fold increase in incidence in the last decade (Rodriguez-Tudela et al, 2015;Lamoth et al, 2018). The average incidence of candidemia in Australia is 2.4/100,000, whereas regionally the range varied from 1.6 to 7.2/100,000 population (Chapman et al, 2017). A recent review summarized data from 39 papers containing reports from across the globe and estimated a total of 159,253 candidemia episodes by August 2017, including a high prevalence in Pakistan followed by Brazil and Russia with the lowest incidence in Jamaica, Austria, and Portugal (Bongomin et al, 2017).…”

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Mechanisms of Pathogenic Candida Species to Evade the Host Complement Attack

Singh

Tóth

Gácser

2020

Front. Cell. Infect. Microbiol.

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Candida species are common colonizers of the human skin, vagina, and the gut. As human commensals, Candida species do not cause any notable damage in healthy individuals; however, in certain conditions they can initiate a wide range of diseases such as chronic disseminated candidiasis, endocarditis, vaginitis, meningitis, and endophthalmitis. The incidence of Candida caused infections has increased worldwide, with mortality rates exceeding 70% in certain patient populations. C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, and C. krusei are responsible for more than 90% of Candida-related infections. Interestingly, the host immune response against these closely related fungi varies. As part of the innate immune system, complement proteins play a crucial role in host defense, protecting the host by lysing pathogens or by increasing their phagocytosis by phagocytes through opsonization. This review summarizes interactions of host complement proteins with pathogenic Candida species, including C. albicans and non-albicans Candida species such as C. parapsilosis. We will also highlight the various ways of complement activation, describe the antifungal effects of complement cascades and explore the mechanisms adopted by members of pathogenic Candida species for evading complement attack.

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Changing epidemiology of candidaemia in Australia

Cited by 115 publications

References 0 publications

Update from a 12-Year Nationwide Fungemia Surveillance: Increasing Intrinsic and Acquired Resistance Causes Concern

Update from a 12-Year Nationwide Fungemia Surveillance: Increasing Intrinsic and Acquired Resistance Causes Concern

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

Mechanisms of Pathogenic Candida Species to Evade the Host Complement Attack

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