Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey
Journal Paper/Review - Sep 17, 2021
Adam Kai-Manuel, Osthoff Michael, Lamoth Frédéric, Conen Anna, Erard Véronique, Boggian Katia, Schreiber Peter W, Zimmerli Stefan, Bochud Pierre-Yves, Neofytos Dionysios, Fleury Mapi, Fankhauser Hans, Goldenberger Daniel, Mühlethaler Konrad, Riat Arnaud, Zbinden Reinhard, Kronenberg Andreas, Quiblier Chantal, Marchetti Oscar, Khanna Nina, Fungal Infection Network of Switzerland (FUNGINOS)
The increasing incidence of candidemia and emergence of drug-resistant species are major concerns worldwide. Long-term surveillance studies are needed.
The Fungal Infection Network of Switzerland (FUNGINOS) conducted a 15-year (2004-2018), nationwide, epidemiological study of candidemia. Hospital-based incidence of candidemia, species distribution, antifungal susceptibility, and consumption were stratified in 3 periods (2004-2008, 2009-2013, 2014-2018). Population-based incidence over the period 2009-2018 derived from the Swiss Antibiotic Resistance Surveillance System (ANRESIS).
A total of 2273 blood isolates were studied. Population and hospital-based annual incidence of candidemia increased from 2.96 to 4.20/100 000 inhabitants ( = .022) and 0.86 to 0.99/10 000 patient-days ( = .124), respectively. The proportion of decreased significantly from 60% to 53% ( = .0023), whereas increased from 18% to 27% ( < .0001). Other non- species remained stable. bloodstream infections occurred predominantly in the age group 18-40 and above 65 years. A higher proportional increase of was recorded in wards (18% to 29%, < .0001) versus intensive care units (19% to 24%, = .22). According to Clinical and Laboratory Standards Institute, nonsusceptibility to fluconazole in was observed in 1% of isolates, and anidulafungin and micafungin nonsusceptibility was observed in 2% of and . Fluconazole consumption, the most frequently used antifungal, remained stable, whereas use of mold-active triazoles and echinocandins increased significantly in the last decade ( < .0001).
Over the 15-year period, the incidence of candidemia increased. A species shift toward was recently observed, concurring with increased consumption of mold-active triazoles.