Epidemiology of Blood Stream Infection due to Candida Species in a Tertiary Care Hospital in Japan over 12 Years: Importance of Peripheral Line-Associated Candidemia

Ishikane, Masahiro; Hayakawa, Kayoko; Kutsuna, Satoshi; Takeshita, Nozomi; Ohmagari, Norio

doi:10.1371/journal.pone.0165346

Cited by 23 publications

(26 citation statements)

References 42 publications

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“…The mean annual incidence in the whole hospital was 1.48 per 10 000 PD and was similar to incidences found in tertiary care hospitals from other developed countries including Canada, Japan and Spain and to the one reported in the same hospital during the period 2001‐2005 (1.51 per 10 000 PD) . The low mean annual incidence (0.59 episodes per 10 000 PD) in the neonatal unit is consistent with the decreasing trend in candidaemia incidence in this unit worldwide .…”

Section: Discussionsupporting

confidence: 85%

“…(1.51 per 10 000 PD). 11,19,24,27,31 The low mean annual incidence (0.59 episodes per 10 000 PD) in the neonatal unit is consistent with the decreasing trend in candidaemia incidence in this unit worldwide. 32 However, the incidence of candidaemia increased significantly between 2004 and 2015 in the other ICUs and drove the increasing incidence of the whole hospital.…”

Section: Discussionsupporting

confidence: 73%

“…Although C. albicans is reported as the main cause of candidaemia worldwide, several reports from India, indicated C. tropicalis as the most prevalent candidaemia‐causing species . Moreover, it has been shown that the species distribution can also vary on a regional scale and even on a local scale within the hospital …”

Section: Introductionmentioning

confidence: 99%

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Increasing candidaemia incidence from 2004 to 2015 with a shift in epidemiology in patients preexposed to antifungals

Goemaere

Becker

Wijngaerden

et al. 2017

Mycoses

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SummaryCandidaemia is an important health problem in immunocompromised patients with an epidemiology varying with region, period and patient population involved. The occurrence of candidaemia and the associated species distribution over a 12-year period at a large tertiary care centre in Belgium were analysed. The trend in incidence in the intensive care units (ICUs) and non-ICUs was investigated as well as the influence of antifungal exposure on the species distribution. From 2004 until 2015, 865 candidaemia episodes occurred in 826 patients at the University Hospitals Leuven. Candida albicans (59%) remained the most important cause of candidaemia, followed by C. glabrata (22.4%) and C. parapsilosis (8%). The mean incidence in the whole hospital was 1.48 per 10 000 patient days (PD). The incidence in ICUs increased reaching up to 10.7 per 10 000 PD whereas in the non-ICUs, the incidence decreased. Prior exposure to fluconazole and echinocandins was associated with candidaemia caused by less susceptible species. Candidaemia incidence increased in the whole hospital, driven by ICUs. Surveillance of candidaemia epidemiology on a local scale is of high value to guide empirical treatment strategies. K E Y W O R D Santifungal agents, Candida spp., candidaemia, epidemiology, incidence

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 73%

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Increasing candidaemia incidence from 2004 to 2015 with a shift in epidemiology in patients preexposed to antifungals

Goemaere

Becker

Wijngaerden

et al. 2017

Mycoses

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“…In the present study, the overall incidence of candidemia was 0.056 cases/1000 hospital admissions, which was lower than that of previous studies in Japan (1.74/1000 hospital admissions). 20 Previous studies reported the incidence of candidemia in the US (0.16–0.33/1000 hospital admissions) and in European countries (0.92–1.5/1000 hospital admissions). 21 – 23 The incidence noted in the present study was similar to that in Finland (0.026–0.03/1000 hospital admissions).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, practice patterns, and prognostic factors for candidemia; and characteristics of fourteen patients with breakthrough <em>Candida</em> bloodstream infections: a single tertiary hospital experience in Japan

Hirano

Sakamoto

Kitazawa

et al. 2018

IDR

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BackgroundCandidemia is associated with high mortality, and its prognostic factors need to be examined in more detail in order to improve its management. A case of breakthrough (BT) candidemia is defined as the development of candidemia during antifungal therapy. The microbiological characteristics of and appropriate clinical practices for BT candidemia remain unclear.ObjectivesThe primary objective of the present study was to identify the prognostic factors of candidemia, while the secondary objective was to elucidate the microbiological characteristics of patients with BT candidemia.Materials and methodsA total of 121 patients diagnosed with candidemia between January 2007 and December 2016 were enrolled in this study. The primary outcome was the 30-day mortality rate.ResultsThe overall incidence of candidemia was 0.056 cases/1000 inpatients. Among the 126 Candida isolated, C. albicans accounted for 36%, C. parapsilosis 26%, C. glabrata 12%, C. guilliermondii 14%, C. tropicalis 3%, C. pelliculos 1%, and other unidentifiable Candida species 8%. The 30-day mortality rate was 33%. In a multivariate Cox hazard analysis, C. albicans, the absence of antifungal therapy, age, lung disease, and mechanical ventilation were associated with a high mortality rate, whereas C. parapsilosis, the removal of a central venous catheter, and surgical wards were associated with a lower mortality rate. Fourteen patients had BT candidemia. A significant difference was observed in the proportion of C. guilliermondii and other Candida species exhibiting resistance to fluconazole and voriconazole, between patients with and without BT candidemia. Resistance to fluconazole was prominent in patients that developed candidemia with a history of azole antifungal agents.ConclusionThe prompt initiation of antifungal therapy and removal of central venous catheter were essential for better outcomes. A class switch to other antifungal agents needs to be considered in empirical antifungal therapy for BT candidemia with a history of exposure to azole antifungal agents.

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“…In the past study [17], we reported that peripheral-line associated candidemia (PLAC) was an important cause of candidemia in the healthcare settings. Although IDC was associated with the predictors of PLAC, we did not evaluate the survival outcome of IDC on candidemia [17].…”

Section: Introductionmentioning

confidence: 99%

The impact of infectious disease consultation in candidemia in a tertiary care hospital in Japan over 12 years

et al. 2019

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Background Candidemia is one of the major causes of morbidity and mortality as a hospital acquired infection. Infectious diseases consultation (IDC) might be beneficial to improve candidemia outcomes; however, only limited data from short periods of time are available thus far. Methods An observational study of all candidemia patients at a large tertiary care hospital between 2002 and 2013 was conducted. A candidemia episode was defined as ≥ 1 positive result for Candida spp. in blood culture. Patients who died or transferred to another hospital within two days after their first positive blood culture were excluded. Independent risk factors for 30-day mortality were determined. Results Among 275 patients with 283 episodes of candidemia, 194 (68.6%) were male, and the mean age was 70.0 ± 15.8 years. Central line-associated bloodstream infections, peripheral line-associated bloodstream infections, intra-abdominal infection, and unknown source comprised 220 (77.7%), 35 (12.4%), 13 (4.7%), and 15 (5.3%) episodes, respectively. A total of 126 patients (44.5%) received IDC. Factors independently associated with 30-day mortality in patients with candidemia were urinary catheters use (adjusted hazard ratio [HR] = 2.94; 95% confidence interval [CI] = 1.48–5.87; P = 0.002) and severe sepsis/septic shock (adjusted HR = 2.10; 95% CI = 1.20–3.65; P = 0.009). IDC was associated with a 46% reduction in 30-day mortality (adjusted HR = 0.54; 95% CI = 0.32–0.90; P = 0.017). Conclusion IDC was independently associated with a reduction in 30-day mortality. Only 44.5% of patients with candidemia in this cohort received IDC. Routine IDC should be actively considered for patients with candidemia.

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Epidemiology of Blood Stream Infection due to Candida Species in a Tertiary Care Hospital in Japan over 12 Years: Importance of Peripheral Line-Associated Candidemia

Cited by 23 publications

References 42 publications

Increasing candidaemia incidence from 2004 to 2015 with a shift in epidemiology in patients preexposed to antifungals

Increasing candidaemia incidence from 2004 to 2015 with a shift in epidemiology in patients preexposed to antifungals

Epidemiology, practice patterns, and prognostic factors for candidemia; and characteristics of fourteen patients with breakthrough <em>Candida</em> bloodstream infections: a single tertiary hospital experience in Japan

The impact of infectious disease consultation in candidemia in a tertiary care hospital in Japan over 12 years

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