Increasing Incidence and Shifting Epidemiology of Candidemia in Greece: Results from the First Nationwide 10-Year Survey

Mamali, Vasiliki; Siopi, Maria; Charpantidis, Stefanos; Samonis, George; Tsakris, Athanassios; Vasilieva, Larisa

doi:10.3390/jof8020116

Cited by 26 publications

(12 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The increased incidence of non -albicans Candida species detected in our study is consistent with comparable data previously reported from our ICU [ 32 ] and elsewhere [ 19 ], as well as with recent data demonstrating an increasing incidence of candidemia in a nationwide study from Greece, with a species shift towards C. parapsilosis [ 33 ]. The increased incidence of non -albicans Candida species is in accordance with an epidemiological shift across the globe, including the emergence of non -albicans Candida species.…”

Section: Discussionsupporting

confidence: 93%

Epidemiology of Candidemia and Fluconazole Resistance in an ICU before and during the COVID-19 Pandemic Era

et al. 2022

Self Cite

View full text Add to dashboard Cite

The objectives of this study were to investigate the incidence of candidemia, as well as the factors associated with Candida species distribution and fluconazole resistance, among patients admitted to the intensive care unit (ICU) during the COVID-19 pandemic, as compared to two pre-pandemic periods. All patients admitted to the ICU due to COVID-19 from March 2020 to October 2021, as well as during two pre-pandemic periods (2005–2008 and 2012–2015), who developed candidemia, were included. During the COVID-19 study period, the incidence of candidemia was 10.2%, significantly higher compared with 3.2% and 4.2% in the two pre-pandemic periods, respectively. The proportion of non-albicans Candida species increased (from 60.6% to 62.3% and 75.8%, respectively), with a predominance of C. parapsilosis. A marked increase in fluconazole resistance (from 31% to 37.7% and 48.4%, respectively) was also observed. Regarding the total patient population with candidemia (n = 205), fluconazole resistance was independently associated with ICU length of stay (LOS) before candidemia (OR 1.03; CI: 1.01–1.06, p = 0.003), whereas the presence of shock at candidemia onset was associated with C. albicans (OR 6.89; CI: 2.2–25, p = 0.001), and with fluconazole-susceptible species (OR 0.23; CI: 0.07–0.64, p = 0.006). In conclusion, substantial increases in the incidence of candidemia, in non-albicansCandida species, and in fluconazole resistance were found in patients admitted to the ICU due to COVID-19, compared to pre-pandemic periods. At candidemia onset, prolonged ICU LOS was associated with fluconazole-resistant and the presence of shock with fluconazole-susceptible species.

show abstract

Section: Discussionsupporting

confidence: 93%

Epidemiology of Candidemia and Fluconazole Resistance in an ICU before and during the COVID-19 Pandemic Era

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…The most commonly reported Candida species with clinical importance in human is relatively finite. The World Health Organization (WHO) have concerned to develop a priority pathogen list for fungal ailments of public health important and to define research and development priorities to enhance innovation for new drugs, diagnostics and strategies (Galia et al, 2022).The most common clinical isolates of Candida species include Candida albicans, Candida tropicalis, Candida glabrata, Candida parapsilosis, Candida krusei, Candida dubliniesis and Candida guilliermondii respectively, and was consistent to the studies conducted by Mamali et al (2022). Mohandas and Ballal (2011) reported that 70.0% of Candida bloodstream infections were caused by biofilmforming agents.…”

Section: Discussionsupporting

confidence: 68%

Effects of biofilm formation and plethora of Candida species causing ailments: a mini review

Amro¹

2022

Gadau J Pure Allied Sci

View full text Add to dashboard Cite

Biofilm formation is an independent predictor of higher mortality rate and significant virulence factor that increase the dissemination ability and persistence of Candida species. However, Candida species distribution differs in population based studies evaluated in different geographical locations. This study aimed to evaluate the biofilm associated mortality rate, spectrum and resistance profile of Candida species. A systemic literature review was carried out to evaluate all current epidemiology that reports the incidence of the biofilm associated mortality rate, spectrum and resistance profile of Candida species. Several studies used optical density of the biomass from culture to measure biofilm formation. Data regarding the prevalence of Candida species, in vitro biofilm assay and rate of biofilm-related Candida species in clinical isolates were also extracted from the case-control, cohort, and retrospective studies. The result of this study shows that the mortality rate due to biofilm associated infections ranged from 6.9% to 70.0% and biofilm formation varied greatly from 27.2% to 100% evaluated from different published studies. Candida albicans was the predominant pathogen and the percentage frequency of the isolates ranged from 36.3% to 78.5%. The distribution of Candida species from 2016 to 2020 revealed that Candida albicans (39.42%) had the highest percentage frequency. High prevalence of Candida species was reported in 2018 (28.2%). The current data revealed that United Kingdom, Spain, Austria and Norway shows resistance profile for Candida tropicalis, Candida albicans, Candida parapsilosis and Candida glabrata. Biofilm formation is considered as potential risk factor of higher mortality rate and effective antifungal agents to eliminate or reduce this menace is urgently needed. The reports of the biofilm-forming potentials and properties among Candida species could provide a remarkable step toward the improvement of Candida infection therapies.

show abstract

“…Despite C. albicans is still the most frequently isolated species, a progressive shift to NAC spp. is recently reported in most parts of the world 17 . Furthermore, species distribution might be affected by the kinds of antifungal drugs empirically used.…”

Section: Discussionmentioning

confidence: 88%

Antifungal susceptibility and virulence determinants profile of candida species isolated from patients with candidemia

Dawoud,

Saied,

Torayah

et al. 2024

Sci Rep

View full text Add to dashboard Cite

Candida is the most prevalent fungal bloodstream infection (BSI) with a high mortality rate among hospitalized patients. Another concern facing physicians is rising global incidence of drug-resistant Candida. This study aimed to characterize the prevalence, antifungal susceptibility, biofilm formation, and virulence genes (HWP1, ALS1, SAP2) of different Candida spp. isolated from patients with candidemia. 52 isolates of Candida spp. were identified from blood cultures by chromogenic Candida agar and confirmed by the VITEK 2 system. Isolates were tested for antifungal susceptibility by disk diffusion and VITEK 2 system. Biofilm formation and investigated genes were detected by the Congo red method and conventional PCR, respectively. Candida spp. caused 2.3% of detected BSIs, of which 32.7% were caused by Candida albicans (C. albicans) and 67.3% by non-albicans Candida (NAC), with the predominance of C. tropicalis (25%), followed by C. parapsilosis (17.3%), and C. krusei (13.5%). The susceptibility rates to fluconazole, voriconazole, caspofungin, micafungin, amphotericin B, and flucytosine were 64.7%, 76.5%, 100.0%, 100%, 100.0%, and 100.0% in C. albicans, while 53.6%, 71.4%, 91.4%, 91.4%, 94.3%, and 94.3% in NAC, respectively. Biofilm production, HWP1, ALS1, and SAP2 were detected in 70.6%, 82.4%, 76.5%, and 52.9% of C. albicans and 74.3%, 85.7%, 80.0%, and 48.6% of NAC, respectively. There is remarkable shift to NAC BSIs and high azole resistance. Antifungal stewardship and analysis of risk factors associated with this shift are needed.

show abstract

Increasing Incidence and Shifting Epidemiology of Candidemia in Greece: Results from the First Nationwide 10-Year Survey

Cited by 26 publications

References 98 publications

Epidemiology of Candidemia and Fluconazole Resistance in an ICU before and during the COVID-19 Pandemic Era

Epidemiology of Candidemia and Fluconazole Resistance in an ICU before and during the COVID-19 Pandemic Era

Effects of biofilm formation and plethora of Candida species causing ailments: a mini review

Antifungal susceptibility and virulence determinants profile of candida species isolated from patients with candidemia

Contact Info

Product

Resources

About