Changing epidemiology of candidaemia in Australia. (8th November 2016)

• Record Type: Journal Article
• Authors: Chapman, Belinda; Slavin, Monica; Marriott, Debbie; Halliday, Catriona; Kidd, Sarah; Arthur, Ian; Bak, Narin; Heath, Christopher H.; Kennedy, Karina; Morrissey, C. Orla; Sorrell, Tania C.; van Hal, Sebastian; Keighley, Caitlin; Goeman, Emma; Underwood, Neil; Hajkowicz, Krispin; Hofmeyr, Ann; Leung, Michael; Macesic, Nenad; Botes, Jeannie; Blyth, Christopher; Cooley, Louise; George, C. Robert; Kalukottege, Pankaja; Kesson, Alison; McMullan, Brendan; Baird, Robert; Robson, Jennifer; Korman, Tony M.; Pendle, Stella; Weeks, Kerry; Liu, Eunice; Cheong, Elaine; Chen, Sharon;
• Other Names: author non-byline.; Daveson K. author non-byline.; Kennedy K. author non-byline.; Wilson H. author non-byline.; Underwood N. author non-byline.; Hajkowicz K. author non-byline.; Thomas M. author non-byline.; Robson J. author non-byline.; Peachey G. author non-byline.; Cheong E. author non-byline.; Gottlieb T. author non-byline.; Lui E. author non-byline.; Pendle S. author non-byline.; Kalukottege R. P. author non-byline.; Hofmeyr A. author non-byline.; Jozwiak F. author non-byline.; George C. R. author non-byline.; Bell S. M. author non-byline.; van Hal S. author non-byline.; Menon V. author non-byline.; Kotsiou G. author non-byline.; Weeks K. author non-byline.; George C. R. author non-byline.; Bell S. M. author non-byline.; Marriott D. author non-byline.; Goeman E. author non-byline.; McMullan B. author non-byline.; Kesson A. author non-byline.; Botes J. author non-byline.; Chen SC-A. author non-byline.; Sorrell T. author non-byline.; Keighley C. author non-byline.; Halliday C. author non-byline.; Baird R. author non-byline.; Marshall C. author non-byline.; Bak N. author non-byline.; Ferguson C. author non-byline.; Kidd S. E. author non-byline.; Cooley L. author non-byline.; Morrissey C. O. author non-byline.; Korman T. author non-byline.; Bryant M. author non-byline.; Slavin M. author non-byline.; Reed C. author non-byline.; Slavin M. author non-byline.; Darvall J. author non-byline.; Maddigan V. author non-byline.; Blyth C. author non-byline.; Leung M. author non-byline.; Arthur I. author non-byline.; Heath C. author non-byline.; Boan P. author non-byline.;
• Is Part Of: Journal of antimicrobial chemotherapy. Volume 72:Number 4(2017:Apr.)
• Page Start: 1103
• Page End: 1108
• Publication Date: 2016-11-08
• Subjects: Anti-infective agents -- Periodicals; Chemotherapy -- Periodicals; 615.58
• DOI: 10.1093/jac/dkw422
• Languages: English
• ISSNs: 0305-7453

Abstract

Abstract : Objectives: Knowledge of contemporary epidemiology of candidaemia is essential. We aimed to identify changes since 2004 in incidence, species epidemiology and antifungal susceptibilities of Candida spp . causing candidaemia in Australia. Methods: These data were collected from nationwide active laboratory-based surveillance for candidaemia over 1 year (within 2014–2015). Isolate identification was by MALDI-TOF MS supplemented by DNA sequencing. Antifungal susceptibility testing was performed using Sensititre YeastOne™. Results: A total of 527 candidaemia episodes (yielding 548 isolates) were evaluable. The mean annual incidence was 2.41/10 5 population. The median patient age was 63 years (56% of cases occurred in males). Of 498 isolates with confirmed species identity, Candida albicans was the most common (44.4%) followed by Candida glabrata complex (26.7%) and Candida parapsilosis complex (16.5%). Uncommon Candida species comprised 25 (5%) isolates. Overall, C. albicans (>99%) and C. parapsilosis (98.8%) were fluconazole susceptible. However, 16.7% (4 of 24) of Candida tropicalis were fluconazole- and voriconazole-resistant and were non-WT to posaconazole. Of C. glabrata isolates, 6.8% were resistant/non-WT to azoles; only one isolate was classed as resistant to caspofungin (MIC of 0.5 mg/L) by CLSI criteria, but was micafungin and anidulafungin susceptible. There was no azole/echinocandin co-resistance. Conclusions: We report an almost 1.7-fold proportional increase in C. glabrata candidaemia (26.7% versus 16% in 2004) in Australia. Antifungal resistance was generally uncommon, but azole resistance (16.7% of isolates) amongst C. tropicalis may be emerging.