One year prospective survey of Candida bloodstream infections in Scotland

Abstract

A 12 month survey of candidaemia in Scotland, UK, in which every Scottish hospital laboratory submitted all blood isolates of yeasts for identification, strain typing and susceptibility testing, provided 300 isolates from 242 patients, generating incidence data of 4.8 cases per 100 000 population per year and 5.9 cases per 100 000 acute occupied bed days; 27.9 % of cases occurred in intensive care units. More than half the patients with candidaemia had an underlying disease involving the abdomen, 78 % had an indwelling intravenous catheter, 62 % had suffered a bacterial infection within the 2 weeks prior to candidaemia and 37 % had undergone a laparotomy. Candida albicans was the infecting species in 50 % of cases, followed by Candida glabrata (21 %) and Candida parapsilosis (12 %). Seven cases of candidaemia were caused by Candida dubliniensis, which was more prevalent even than Candida lusitaniae and Candida tropicalis (six cases each). Among C. glabrata isolates, 55 % showed reduced susceptibility to fluconazole, but azole resistance among other species was extremely low. Multilocus sequence typing showed isolates with high similarity came from different hospitals across the country, and many different types came from the hospitals that submitted the most isolates, indicating no tendency towards hospital-specific endemic strains. Multiple isolates of C. albicans and C. glabrata from individual patients were of the same strain type with single exceptions for each species. The high prevalence of candidaemia in Scotland, relative to other population-based European studies, and the high level of reduced fluconazole susceptibility of Scottish C. glabrata isolates warrant continued future surveillance of invasive Candida infections.

Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt

“…Our susceptibility data were similar to those of other studies, and confirmed low levels of antifungal resistance among C. albicans isolates but a high level of reduced fluconazole and also reduced amphotericin B susceptibility among C. glabrata and C. krusei isolates [22,25]. There was considerable agreement between our Etest-MICs results for antifungals including those for amphotericin B, for which clinical breakpoints have not been established yet, and the EUCAST reference method [26,27].…”

Differential virulence of Candida albicansandC. dubliniensis: A role for Tor1 kinase?

“…Analysis of the incidence of C. dubliniensis in bloodstream infection shows that this organism is responsible for fewer than 2% of systemic Candida infections compared with over 60% by C. albicans. 6,7 Data from animal models of infection confirm that C. dubliniensis isolates are less virulent than C. albicans. In the oral-intragastric murine infection model, C. dubliniensis colonized mice less efficiently than C. albicans and were less able to establish systemic infection.…”

Historical trends in the epidemiology of candidaemia: analysis of an 11-year period in a tertiary care hospital in Brazil

“…Bloodstream infections (BSI) caused by Candida species are an important cause of morbidity and mortality in hospitalised patients worldwide (Zaoutis et al 2005, Odds et al 2007, Pfaller & Diekema 2007, Hsueh & Ruan 2009. Candidaemia is generally difficult to diagnose and treat and mortality rates remain at approximately 50%, with great costs to the healthcare system (Gudlaugsson et al 2003, Colombo et al 2008, Arnold et al 2010.…”