Emerging trends in candidemia: A higher incidence but a similar outcome

Fortün, Jesús; Martín-Dávila, Pilar; Pedrosa, Elia Gómez-García de la; Pintado, Vicente; Cobo, Javier; Fresco, Gema; Meije, Yolanda; Ros, Lilica; Alvarez, M.E.; Luengo, Juliana de Moura Leite; Agúndez, María Carmona; Belso, A.; Sánchez‐Sousa, A.; Loza, Elena; Moreno, Santiago

doi:10.1016/j.jinf.2012.02.011

Cited by 67 publications

(54 citation statements)

References 21 publications

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“…Though candidiasis can occur at all ages, studies by one study has shown that the highest incidence of candidiasis was in the age group over 50 years. 27 This feature has been corroborated in our study where 281 (50.6%) of all fungal isolates, including Candida spp were from patients of age group over 50 years. Studies over the years have shown that there is a considerable increase in the NAC isolates.…”

Section: Discussionsupporting

confidence: 78%

Common fungal isolates from routine clinical specimens: a two years’ studyfrom a tertiary care hospital in South India

et al. 2017

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Background: Fungal infections are gaining prominence in recent years and are becoming a cause of significant morbidity as well as mortality. Reliable data from India about the spectrum of pathogens causing fungal infection in various body systems, and particularly about the antifungal susceptibility pattern of Candida spp., which is the most common isolate worldwide is not available. Methods:We prospectively studied 48,155 clinical samples submitted for fungal work-up to the microbiology laboratory at our tertiary care teaching hospital. Standard procedures were followed for fungal identification. Candida isolates were differentiated into Candida albicans and non-albicans candida (NAC) by germ tube test. Antifungal susceptibility of Candida isolates was determined by disc diffusion technique using amphotericin B (10 µg), fluconazole (25 µg), and voriconazole (1 µg) discs.Results: A total of 555 fungal isolates were obtained of which 541 were Candida spp, while the others were filamentous fungi. Male gender and age over 50 years were found to be independent risk factors. Proportion of NAC isolates (n = 384, 69.2%) were greater compared to C. albicans (n = 157, 28.3%). Aspergillus spp. was the second most frequent isolate. Azole resistance was significantly more in NAC group as compared to C. albicans. For fluconazole, 57.5% of the NAC showed resistance compared to 24.8% seen in strains of C. albicans while the corresponding figure for voriconazole was 56.8% Vs 22.9%. Overall resistance for amphotericin B was low (8.9%). Conclusions:Our observations bring to light the spectrum of common fungal isolates and their susceptibility patterns. This information will be useful for health planners and policy makers, as early institution of appropriate antifungal treatment can be life saving. Key words: Mycoses, Antifungal susceptibility testing, CandidaJayaprada R, Nagaraja M, Sumanth Kumar GLS, Venkataramana B, Kalawat U. Common fungal isolates from routine clinical specimens -A two-year study from a tertiary care hospital in South India. J Clin Sci Res 2017;6:2-9. DOI: http:// dx

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Section: Discussionsupporting

confidence: 78%

Common fungal isolates from routine clinical specimens: a two years’ studyfrom a tertiary care hospital in South India

et al. 2017

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“…Therefore, changes in our demographics do not appear to be the primary driver of this pathogenic shift. Similar trends in rates of fungal infection have been demonstrated elsewhere, although the most common Candida species differs by institution [13,[15][16][17][18]. One study found blood transfusion to be an independent risk factor for non-Candida albicans fungemia [19].…”

Section: Discussionsupporting

confidence: 63%

“…Surprisingly, we also demonstrated lower rates of C. glabrata in patients who received fluconazole compared with other fungal isolates. Fluconazole use has received mixed reviews as a cause of non-albicans candidemia, with studies supporting both sides of the debate [15,17,[20][21][22][23][24][25]. Our findings add to the dispute in this area.…”

Section: Discussionmentioning

confidence: 55%

Temporal Trends in Blood Stream Infection Isolates from Surgical Patients

Guidry

Rosenberger

Petroze

et al. 2015

Surgical Infections

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Background: Blood stream infections (BSIs) are a common source of morbidity and death in hospitalized patients. We hypothesized that the proportions of bacteremia from gram-positive and fungal pathogens have decreased over time, whereas rates of gram-negative bacteremia have increased as a result of better central venous catheter management. Methods: All U.S. Centers for Disease Control and Prevention-defined BSIs in patients treated on the general surgery and trauma services at our institution between January 1, 1998, and December 31, 2009 were identified prospectively. These cases were analyzed on a yearly basis to compare rates of various infections over time. The Cochran-Armitage test for trend was used to evaluate categorical data, whereas the Jonckheere-Terpstra test for ordered values was used to analyze continuous data. Results: A total of 1,040 patients had 1,441 episodes of BSI caused by 1,632 strains of bacteria or fungi. There was no difference over time in the proportion of BSI among overall infections. Rates of BSI for gramnegative and fungal pathogens increased over time (p = 0.03 and < 0.0001, respectively), whereas rates of grampositive BSI decreased (p < 0.0001). Positive changes in anaerobic BSI approached statistical significance. Conclusion: Although our hypothesis was only partly true, over the last 12 y, our institution clearly has witnessed a shift in the types of organisms causing BSIs. There was a decrease in the rates of BSI caused by gram-positive pathogens with an associated increase in the rates of BSI of infections by fungal and gramnegative pathogens. Interventions to reduce institutional rates of BSI should include targeted therapies based on historical institutional trends.

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“…The secular trends of incidence of Candida infections, in particular Candida bloodstream infections, have been increasing over the past few decades across the globe [13][14][15][16][17][18][19][20][21][22] (Table 1). This could be attributed to the increased number of immunocompromised patients due to the growing widespread use of medical procedures, for instance the use of immunosuppressive drugs and broad-spectrum antibiotics, as well as invasive surgical procedures such as solid organ transplantation [23].…”

Section: Increased Incidence Of Invasive Candidiasismentioning

confidence: 99%