Epidemiology of Candidemia in Swiss Tertiary Care Hospitals: Secular Trends, 1991–2000

Abstract

Candida species are among the most common bloodstream pathogens in the United States, where the emergence of azole-resistant Candida glabrata and Candida krusei are major concerns. Recent comprehensive longitudinal data from Europe are lacking. We conducted a nationwide survey of candidemia during 1991-2000 in 17 university and university-affiliated hospitals representing 79% of all tertiary care hospital beds in Switzerland. The number of transplantations and bloodstream infections increased significantly (P<.001). A total of 1137 episodes of candidemia were observed: Candida species ranked seventh among etiologic agents (2.9% of all bloodstream isolates). The incidence of candidemia was stable over a 10-year period. C. albicans remained the predominant Candida species recovered (66%), followed by C. glabrata (15%). Candida tropicalis emerged (9%), the incidence of Candida parapsilosis decreased (1%), and recovery of C. krusei remained rare (2%). Fluconazole consumption increased significantly (P<.001). Despite increasing high-risk activities, the incidence of candidemia remained unchanged, and no shift to resistant species occurred.

Seminational Surveillance of Fungemia in Denmark: Notably High Rates of Fungemia and Numbers of Isolates with Reduced Azole Susceptibility

“…It is somewhat surprising that the Danish figures seem to differ distinctively from those of the other Nordic countries and to approach the American ones, as Denmark and the other Nordic countries are known for a restrictive use of antimicrobial agents. Also, the epidemiology does not seem to follow a current trend in some American and European studies where rates of candidemia are leveling off or even decreasing after a continuous rise in the 1980s and early 1990s (11,17,24,26). Moreover, in Denmark, the number of C. albicans as well as non-C. albicans cases has also been rising in contrast to recent findings elsewhere (11,24,26).…”

“…Overall, the incidence has been rising over the past decades, although recent studies from intensive care units in the United States and tertiary hospitals in Switzerland have shown a decrease (11,24,26). Variations in the rate and species distribution between countries and hospital settings are prominent.…”

Epidemiology of Bloodstream Candida spp. Infections Observed During a Surveillance Study Conducted in Spain

“…For instance, in The Netherlands an increasing incidence of candidemia has been reported during the period between eighties and nineties (Voss et al, 1996) but on the other hand, in a neighbouring country such as Switzerland the incidence of Candida BSI infections remained unchanged during the same period (Marchetti et al, 2004). Therefore, it seems that there are some differences in the epidemiology of candidemia between different countries.…”

Prevalence of yeast fungal infections in intensive care unit in Poland

“…Fungi of the Candida species are responsible for life-threatening, nosocomial infections in medical Intensive Care Units (ICUs) with an incidence ranging from 0.74% to 1.9% of all patients admitted [1,2]. Mortality associated with fungal infections in patients hospitalized in ICUs reaches 67% [3].…”

“…Mortality associated with fungal infections in patients hospitalized in ICUs reaches 67% [3]. Most common species of Candida fungi are C. albicans, followed by C. glabrata [2]. Known risk factors that predispose to candidiasis are: trauma, immunosuppression, prolonged hospital stay, diabetes, mechanical ventilation, urinary tract catheterization, and central venous catheterization [4].…”