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Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey

Journal Paper/Review - Sep 17, 2021

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Citation
Adam K, Osthoff M, Lamoth F, Conen A, Erard V, Boggian K, Schreiber P, Zimmerli S, Bochud P, Neofytos D, Fleury M, Fankhauser H, Goldenberger D, Mühlethaler K, Riat A, Zbinden R, Kronenberg A, Quiblier C, Marchetti O, Khanna N, Fungal Infection Network of Switzerland (FUNGINOS). Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey. Open Forum Infect Dis 2021; 8:ofab471.
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Type
Journal Paper/Review (English)
Journal
Open Forum Infect Dis 2021; 8
Publication Date
Sep 17, 2021
Issn Print
2328-8957
Issn Electronic
Pages
ofab471
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Brief description/objective

Background
The increasing incidence of candidemia and emergence of drug-resistant species are major concerns worldwide. Long-term surveillance studies are needed.

Methods
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).

Results
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).

Conclusions
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.