The epidemiology and management of candidemia in Northern Ireland during 2002−2011, including a 12-month enhanced case review

Spiers, Rachel; Smyth, B.; Lamagni, Theresa; Rooney, Paul J.; Dorgan, Eileen; Wyatt, T. D.; Geoghegan, Lourda; Patterson, Lynsey

doi:10.1093/mmy/myx165

Cited by 13 publications

(18 citation statements)

References 19 publications

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“…In contrast, the resistance rates in our study were lower than those in Nanjing [27]. Regarding other countries, the antifungal resistance rate in our study was higher than that reported in northern Ireland in 2007–2011 [36]. The resistance rate of azoles in C. albicans (< 5%) [40] worldwide was significantly lower than that in our study (> 20.0%).…”

Section: Discussioncontrasting

confidence: 86%

“…Our studies showed that the ITR resistance rate was the highest, at 23.1% in all Candida species, followed by FCA (18.6%), VRC (18.5%) and 5-FC (4.1%). However, none of the isolates in this study were resistant to AMB, and the susceptibility results in our city were higher than those in northern Ireland (susceptibility, 99.1%) [36]. In China, the resistance rates vary significantly among different cities.…”

Section: Discussionmentioning

confidence: 69%

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Surveillance study of the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of invasive candidiasis in a tertiary teaching hospital in Southwest China

et al. 2019

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Background Invasive candidiasis (IC) is the most common invasive fungal infection. The epidemiology of IC in hospitalized patients has been widely investigated in many metropolitan cities; however, little information from medium and small cities is known. Methods A 5-year retrospective study was carried out to analyze the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of inpatients with invasive Candida infection in a regional tertiary teaching hospital in Southwest China. Results A total of 243 inpatients with invasive Candida infection during the five-year study period were identified, with a mean annual incidence of 0.41 cases per 1000 admissions and a 30-day mortality rate of 12.3%. The species distributions of Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei, Candida parapsilosis and other Candida species was 45.3, 30.0, 15.2, 4.9, 2.1 and 2.5%, respectively. The total resistance rates of fluconazole (FCA), itraconazole (ITR) and voriconazole (VRC) were 18.6, 23.1 and 18.5%, respectively. Respiratory dysfunction, pulmonary infection, cardiovascular disease, chronic/acute renal failure, mechanical ventilation, abdominal surgery, intensive care in adults, septic shock and IC due to C. albicans were associated with 30-day mortality (P < 0.05) according to the univariate analyses. Respiratory dysfunction [odds ratio (OR), 9.80; 95% confidence interval (CI), 3.24–29.63; P < 0.001] and IC due to C. albicans (OR, 3.35; 95% CI, 1.13–9.92; P = 0.029) were the independent predictors of 30-day mortality. Conclusions This report shows that the incidence and mortality rates are lower and that the resistance rates to azoles are higher in medium and small cities than in large cities and that the species distributions and risk factors in medium and small cities are different from those in large cities in China. It is necessary to conduct epidemiological surveillance in medium and small cities to provide reference data for the surveillance of inpatients with IC infections.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 69%

Surveillance study of the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of invasive candidiasis in a tertiary teaching hospital in Southwest China

et al. 2019

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“…The incidence of 0.47 per 1,000 admissions (IQR 0.25–0.78) was similar to those reported in Australia [27], Belgium [28] and Spain [29] (0.21, 0.44 and 0.58 per 1,000 admissions, respectively) and lower than reported by Northern Ireland [30], Italy [31], Peru [18] and Brazil [19] (1.09, 1.73, 2.04, 2.49 per 1,000 admissions respectively). In a recent study that explored contributing factors for the Candida spp.…”

Section: Discussionsupporting

confidence: 85%

A prospective, multi-center study of Candida bloodstream infections in Chile

et al. 2019

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Background Active surveillance is necessary for improving the management and outcome of patients with candidemia. The aim of this study was to describe epidemiologic and clinical features of candidemia in children and adults in tertiary level hospitals in Chile. Methods We conducted a prospective, multicenter, laboratory-based survey study of candidemia in 26 tertiary care hospitals in Chile, from January 2013 to October 2017. Results A total of 780 episodes of candidemia were included, with a median incidence of 0.47/1,000 admissions. Demographic, clinical and microbiological information of 384 cases of candidemia, from 18 hospitals (7,416 beds), was included in this report. One hundred and thirty-four episodes (35%) occurred in pediatric patients and 250 (65%) in adult population. Candida albicans (39%), Candida parapsilosis (30%) and Candida glabrata (10%) were the leading species, with a significant difference in the distribution of species between ages. The use of central venous catheter and antibiotics were the most frequent risk factors in all age groups (> 70%). Three hundred and fifteen strains were studied for antifungal susceptibility; 21 strains (6.6%) were resistant to fluconazole, itraconazole, voriconazole, anidulafungin or micafungin. The most commonly used antifungal therapies were fluconazole (39%) and echinocandins (36%). The overall 30-day survival was 74.2%, significantly higher in infants (82%) and children (86%) compared with neonates (72%), adults (71%) and elderly (70%). Conclusions Our prospective, multicenter surveillance study showed a low incidence of candidemia in Chile, with high 30-day survival, a large proportion of elderly patients, C . glabrata as the third most commonly identified strain, a 6.6% resistance to antifungal agents and a frequent use of echinocandins.

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“…Despite the significant differences in the overall EQUAL scores, we were reassured that the 30‐day survival was similar across age groups in our setting. However, the overall 30‐day all‐cause mortality from candidaemia in our study was still high at 32% but lower compared to 41% in Scotland overall, 18 35.1% in Northern Ireland 19 and 38% in Europe 20 . The difference favouring survival of the younger patients in our study was significant at the 90‐day time point when compared to the very elderly patients.…”

Section: Discussioncontrasting

confidence: 65%

Candidaemia in the elderly: Epidemiology, management and adherence to the European Confederation of Medical Mycology quality indicators

Bal

Palchaudhuri

2020

Mycoses

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Summary Background Candidaemia in the elderly has not been extensively investigated. Objectives We compared the management of candidaemia in the elderly patients (age ≥65 years) and the very elderly subgroup of patients (age ≥75 years) with those belonging to the younger group (age <65 years) using the European Confederation of Medical Mycology (ECMM) Quality (EQUAL) standard. Patients & Methods Over a 10‐year period (April 2011‐March 2020), patients with candida bloodstream infection were identified. Data pertaining to demographics, clinical risk factors, antifungal treatment, central venous catheter and investigations such as echocardiogram and fundoscopy were obtained from electronic sources and medical case notes. Results A total of 174 episodes of candidaemia were recorded, comprising of 74 episodes in younger patients and 100 in the elderly, of whom 56 were in the very elderly patients. Of the 177 Candida species recovered, 79 were Candida albicans. EQUAL scores were analysed for 148 patients. The mean score was significantly lower in the elderly (10.4) and the very elderly (9.7) patients compared to the patients in the younger age group (12.19) (P < .01). In particular, this was due to lower blood culture volume drawn (P < .01) and, in the very elderly group, significantly lower scores for the quality indicators pertaining to echocardiogram and fundoscopy (P = .03). The overall mean EQUAL score was 11.16 (median 11; interquartile range 8‐14). The 30‐day survival was 68% and was similar between all groups. Conclusions Areas of improvement were identified in the management of candidaemia in the elderly patients.

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The epidemiology and management of candidemia in Northern Ireland during 2002−2011, including a 12-month enhanced case review

Cited by 13 publications

References 19 publications

Surveillance study of the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of invasive candidiasis in a tertiary teaching hospital in Southwest China

Surveillance study of the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of invasive candidiasis in a tertiary teaching hospital in Southwest China

A prospective, multi-center study of Candida bloodstream infections in Chile

Candidaemia in the elderly: Epidemiology, management and adherence to the European Confederation of Medical Mycology quality indicators

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