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 BotesChristopher 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

    66 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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