Epidemiology of fungaemia in Sweden: A nationwide retrospective observational survey

Mycoses. 2018 Oct;61(10):777-785. doi: 10.1111/myc.12816. Epub 2018 Jul 18.

Abstract

Objectives: To identify the epidemiology and antifungal susceptibilities of Candida spp. among blood culture isolates to identify the epidemiology and antifungal susceptibilities of Candida spp. among blood culture isolates in Sweden.

Methods: The study was a retrospective, observational nationwide laboratory-based surveillance for fungaemia and fungal meningitis and was conducted from September 2015 to August 2016.

Results: In total, 488 Candida blood culture isolates were obtained from 471 patients (58% males). Compared to our previous study, the incidence of candidaemia has increased from 4.2/100 000 (2005-2006) to 4.7/100 000 population/year (2015-2016). The three most common Candida spp. isolated from blood cultures were Candida albicans (54.7%), Candida glabrata (19.7%) and species in the Candida parapsilosis complex (9.4%). Candida resistance to fluconazole was 2% in C. albicans and between 0% and 100%, in non-albicans species other than C. glabrata and C. krusei. Resistance to voriconazole was rare, except for C. glabrata, C. krusei and C. tropicalis. Resistance to anidulafungin was 3.8% while no Candida isolate was resistant to amphotericin B.

Conclusions: We report an overall increase in candidaemia but a minor decrease of C. albicans while C. glabrata and C. parapsilosis remain constant over this 10-year period.

Keywords: Candida; Cryptococcus; antifungal susceptibility; candidaemia; fungaemia epidemiology; fungal meningitis epidemiology; incidence.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / pharmacology
  • Candida / classification*
  • Candida / drug effects
  • Candida / isolation & purification*
  • Candidemia / epidemiology*
  • Candidemia / etiology
  • Child
  • Child, Preschool
  • Drug Resistance, Fungal
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Meningitis, Fungal / epidemiology
  • Meningitis, Fungal / etiology
  • Microbial Sensitivity Tests
  • Middle Aged
  • Retrospective Studies
  • Sweden / epidemiology
  • Young Adult

Substances

  • Antifungal Agents

Grants and funding