1. Changing epidemiology of candidaemia in Australia.
- Author
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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, and Botes, Jeannie
- Subjects
CANDIDEMIA ,SOCIAL epidemiology ,ANTIFUNGAL agents ,ECHINOCANDINS ,PUBLIC health ,CANDIDA ,DRUG resistance in microorganisms ,HETEROCYCLIC compounds ,MASS spectrometry ,MICROBIAL sensitivity tests ,PEPTIDES ,DISEASE incidence ,FLUCONAZOLE ,SEQUENCE analysis ,VORICONAZOLE ,PHARMACODYNAMICS - 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 2.41/105 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. [ABSTRACT FROM AUTHOR]- Published
- 2017
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