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Increasing candidaemia incidence from 2004 to 2015 with a shift in epidemiology in patients preexposed to antifungals
Author(s) -
Goemaere Berdieke,
Becker Pierre,
Van Wijngaerden Eric,
Maertens Johan,
Spriet Isabel,
Hendrickx Marijke,
Lagrou Katrien
Publication year - 2018
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12714
Subject(s) - incidence (geometry) , fluconazole , medicine , epidemiology , intensive care , candida parapsilosis , echinocandins , candida albicans , invasive candidiasis , emergency medicine , intensive care medicine , pediatrics , antifungal , biology , caspofungin , microbiology and biotechnology , physics , dermatology , optics
Summary Candidaemia is an important health problem in immunocompromised patients with an epidemiology varying with region, period and patient population involved. The occurrence of candidaemia and the associated species distribution over a 12‐year period at a large tertiary care centre in Belgium were analysed. The trend in incidence in the intensive care units ( ICU s) and non‐ ICU s was investigated as well as the influence of antifungal exposure on the species distribution. From 2004 until 2015, 865 candidaemia episodes occurred in 826 patients at the University Hospitals Leuven. Candida albicans (59%) remained the most important cause of candidaemia, followed by C. glabrata (22.4%) and C. parapsilosis (8%). The mean incidence in the whole hospital was 1.48 per 10 000 patient days (PD). The incidence in ICU s increased reaching up to 10.7 per 10 000 PD whereas in the non‐ ICU s, the incidence decreased. Prior exposure to fluconazole and echinocandins was associated with candidaemia caused by less susceptible species. Candidaemia incidence increased in the whole hospital, driven by ICU s. Surveillance of candidaemia epidemiology on a local scale is of high value to guide empirical treatment strategies.