CandidaBloodstream Infections in Italy: Changing Epidemiology during 16 Years of Surveillance

Abstract

Although considerable progress has been made in the management of patients with invasive fungal infections, Candida bloodstream infections are still widespread in hospital settings. Incidence rates vary geographically, often because of different patient populations. The aim of the present study was to describe the epidemiology of candidemia, to analyze the trend of species distribution, and to measure the in vitro susceptibility to antifungal drugs in a university Italian hospital from 1998 to 2013. The antifungal susceptibility for all Candida isolates was evaluated by broth microdilution assay (CLSI M27-A3 document). Of 394 episodes of candidemia, the average incidence was 3.06/10 000 admissions. C. albicans and non-albicans Candida species caused 44.2% and 55.8% of the episodes, respectively. C. parapsilosis (62.2%) was the most common non-albicans. C. albicans predominated in almost all departments whereas C. parapsilosis was found in adult and paediatric oncohaematology units (34.8% and 77.6%, resp.). Overall, mortality occurred in 111 (28.2%) patients. Death occurred most often in intensive care units (47.1%) and specialist surgeries (43.7%). Most of the isolates were susceptible to antifungal drugs, but there was an upward trend for azole (P < 0.05). In conclusion, this study emphasizes the importance of monitoring local epidemiologic data and the diversity of patient groups affected.

Prognostic factors for candidaemia in intensive care unit patients: a retrospective analysis

“…Our results indicate a relatively high rate when compared with recent studies that reported a rate of 3.06 per 10,000 admissions in an Italian general ward (18) and 15.1 per 10,000 admissions in a Chinese ICU population. (24) This variability in the incidence rates of candidaemia among different countries may be reflective of differences in their healthcare systems, patient backgrounds and/or surveillance methods.…”

“…‡Although the criteria for the severity of disease were not clear, it was defined as an Acute Physiology and Chronic Health Evaluation (APACHE) II score > 20 in the present study, as an APACHE II score > 20 during candidaemia was found to be associated with an elevated mortality rate in a previous study. (18) cumulative number of risk factors for invasive candidiasis had the larger AUROC.…”

Candida parapsilosis Secreted Lipase as an Important Virulence Factor

“…Recent studies detail that invasive candidiasis is the leading cause of mycosis-associated mortality worldwide [4][5][6][7]. Although the opportunistic pathogen Candida albicans is the most common species found in the hospital environment, numerous non-albicans Candida (NAC) species have been isolated from patients as a source of primary infection [8,9].…”

Antihypertensive, Amlodipine Besilate Inhibits Growth and Biofilm of Human Fungal PathogenCandida

“…5 In a 16-year surveillance study, 394 cases of candidemia per 10,000 admissions have been reported from an Italian hospital where Candida albicans was present in 44.2% cases, followed by Candida parapsilosis and Candida glabrata. 6 A surveillance study from a Mexican tertiary care center on BSI revealed that C. albicans (46%) and Candida tropicalis (26%) were dominant among other species, whereas C. glabrata was more prevalent in diabetic and old age persons. 7 Non-albicans Candida (NAC) species were predominant in HIV seropositive patients admitted at HAART center in Gujarat, followed by C. albicans.…”