Changing epidemiology of candidaemia in Australia

Belinda Chapman, Monica A. Slavin, Debbie Marriott, Catriona Halliday, Sarah Kidd, Ian Arthur, Narin Bak, Christopher H Heath, Karina Kennedy, C Orla Morrissey, Tania C Sorrell, Sebastian van Hal, Caitlin Keighley, Emma Goeman, Neil Underwood, Krispin Hajkowicz, Ann Hofmeyr, Michael Leung, Nenad Macesic, Jeannie Botes & 15 others Christopher Blyth, Louise Cooley, C Robert George, Pankaja Kalukottege, Alison Kesson, Brendan J. McMullan, Robert Baird, Jennifer Robson, Tony M. Korman, Stella Pendle, Kerry Weeks, Eunice Liu, Elaine Cheong, Sharon Chen, Australian and New Zealand Mycoses Interest Group

    Research output: Contribution to journalArticle

    36 Citations (Scopus)

    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.

    Original languageEnglish
    Article numberhttps://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422
    Pages (from-to)1103-1108
    Number of pages6
    JournalJournal of Antimicrobial Chemotherapy
    Volume72
    Issue number4
    DOIs
    Publication statusPublished - 1 Apr 2017

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    Candidemia
    Epidemiology
    Candida glabrata
    Azoles
    Candida
    Candida tropicalis
    Fluconazole
    caspofungin
    Candida albicans
    anidulafungin
    Echinocandins
    Matrix-Assisted Laser Desorption-Ionization Mass Spectrometry
    Incidence
    DNA Sequence Analysis
    Population

    Cite this

    Chapman, B., Slavin, M. A., Marriott, D., Halliday, C., Kidd, S., Arthur, I., ... Australian and New Zealand Mycoses Interest Group (2017). Changing epidemiology of candidaemia in Australia. Journal of Antimicrobial Chemotherapy, 72(4), 1103-1108. [https://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422]. https://doi.org/10.1093/jac/dkw422
    Chapman, Belinda ; Slavin, Monica A. ; 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 ; Botes, Jeannie ; Blyth, Christopher ; Cooley, Louise ; George, C Robert ; Kalukottege, Pankaja ; Kesson, Alison ; McMullan, Brendan J. ; Baird, Robert ; Robson, Jennifer ; Korman, Tony M. ; Pendle, Stella ; Weeks, Kerry ; Liu, Eunice ; Cheong, Elaine ; Chen, Sharon ; Australian and New Zealand Mycoses Interest Group. / Changing epidemiology of candidaemia in Australia. In: Journal of Antimicrobial Chemotherapy. 2017 ; Vol. 72, No. 4. pp. 1103-1108.
    @article{2674f7100f24474c8494ad83ba944588,
    title = "Changing epidemiology of candidaemia in Australia",
    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.",
    keywords = "Journal Article",
    author = "Belinda Chapman and Slavin, {Monica A.} and Debbie Marriott and Catriona Halliday and Sarah Kidd and Ian Arthur and Narin Bak and Heath, {Christopher H} and Karina Kennedy and Morrissey, {C Orla} and Sorrell, {Tania C} and {van Hal}, Sebastian and Caitlin Keighley and Emma Goeman and Neil Underwood and Krispin Hajkowicz and Ann Hofmeyr and Michael Leung and Nenad Macesic and Jeannie Botes and Christopher Blyth and Louise Cooley and George, {C Robert} and Pankaja Kalukottege and Alison Kesson and McMullan, {Brendan J.} and Robert Baird and Jennifer Robson and Korman, {Tony M.} and Stella Pendle and Kerry Weeks and Eunice Liu and Elaine Cheong and Sharon Chen and {Australian and New Zealand Mycoses Interest Group}",
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    Chapman, B, Slavin, MA, Marriott, D, Halliday, C, Kidd, S, Arthur, I, Bak, N, Heath, CH, Kennedy, K, Morrissey, CO, Sorrell, TC, van Hal, S, Keighley, C, Goeman, E, Underwood, N, Hajkowicz, K, Hofmeyr, A, Leung, M, Macesic, N, Botes, J, Blyth, C, Cooley, L, George, CR, Kalukottege, P, Kesson, A, McMullan, BJ, Baird, R, Robson, J, Korman, TM, Pendle, S, Weeks, K, Liu, E, Cheong, E, Chen, S & Australian and New Zealand Mycoses Interest Group 2017, 'Changing epidemiology of candidaemia in Australia' Journal of Antimicrobial Chemotherapy, vol. 72, no. 4, https://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422, pp. 1103-1108. https://doi.org/10.1093/jac/dkw422

    Changing epidemiology of candidaemia in Australia. / Chapman, Belinda; Slavin, Monica A.; 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; Botes, Jeannie; Blyth, Christopher; Cooley, Louise; George, C Robert; Kalukottege, Pankaja; Kesson, Alison; McMullan, Brendan J.; Baird, Robert; Robson, Jennifer; Korman, Tony M.; Pendle, Stella; Weeks, Kerry; Liu, Eunice; Cheong, Elaine; Chen, Sharon; Australian and New Zealand Mycoses Interest Group.

    In: Journal of Antimicrobial Chemotherapy, Vol. 72, No. 4, https://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422, 01.04.2017, p. 1103-1108.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Changing epidemiology of candidaemia in Australia

    AU - Chapman, Belinda

    AU - Slavin, Monica A.

    AU - Marriott, Debbie

    AU - Halliday, Catriona

    AU - Kidd, Sarah

    AU - Arthur, Ian

    AU - Bak, Narin

    AU - Heath, Christopher H

    AU - Kennedy, Karina

    AU - Morrissey, C Orla

    AU - Sorrell, Tania C

    AU - van Hal, Sebastian

    AU - Keighley, Caitlin

    AU - Goeman, Emma

    AU - Underwood, Neil

    AU - Hajkowicz, Krispin

    AU - Hofmeyr, Ann

    AU - Leung, Michael

    AU - Macesic, Nenad

    AU - Botes, Jeannie

    AU - Blyth, Christopher

    AU - Cooley, Louise

    AU - George, C Robert

    AU - Kalukottege, Pankaja

    AU - Kesson, Alison

    AU - McMullan, Brendan J.

    AU - Baird, Robert

    AU - Robson, Jennifer

    AU - Korman, Tony M.

    AU - Pendle, Stella

    AU - Weeks, Kerry

    AU - Liu, Eunice

    AU - Cheong, Elaine

    AU - Chen, Sharon

    AU - Australian and New Zealand Mycoses Interest Group

    PY - 2017/4/1

    Y1 - 2017/4/1

    N2 - 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.

    AB - 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.

    KW - Journal Article

    U2 - 10.1093/jac/dkw422

    DO - 10.1093/jac/dkw422

    M3 - Article

    VL - 72

    SP - 1103

    EP - 1108

    JO - Journal of Antimicrobial Chemotherapy

    JF - Journal of Antimicrobial Chemotherapy

    SN - 0305-7453

    IS - 4

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    ER -

    Chapman B, Slavin MA, Marriott D, Halliday C, Kidd S, Arthur I et al. Changing epidemiology of candidaemia in Australia. Journal of Antimicrobial Chemotherapy. 2017 Apr 1;72(4):1103-1108. https://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422. https://doi.org/10.1093/jac/dkw422