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; 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

doi:10.1093/jac/dkw422

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

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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 language	English
Article number	https://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422
Pages (from-to)	1103-1108
Number of pages	6
Journal	Journal of Antimicrobial Chemotherapy
Volume	72
Issue number	4
DOIs	https://doi.org/10.1093/jac/dkw422
Publication status	Published - 1 Apr 2017

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10.1093/jac/dkw422

https://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422

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Chapman, B., Slavin, M. A., Marriott, D., Halliday, C., Kidd, S., Arthur, I., Bak, N., Heath, C. H., Kennedy, K., Morrissey, C. O., Sorrell, T. C., van Hal, S., Keighley, C., Goeman, E., Underwood, N., Hajkowicz, K., Hofmeyr, A., Leung, M., Macesic, N., ... Australian and New Zealand Mycoses Interest Group (2017). Changing epidemiology of candidaemia in Australia. Journal of Antimicrobial Chemotherapy, 72(4), 1103-1108. Article https://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422. https://doi.org/10.1093/jac/dkw422

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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{\texttrademark}.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.",

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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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doi = "10.1093/jac/dkw422",

language = "English",

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pages = "1103--1108",

journal = "Journal of Antimicrobial Chemotherapy",

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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

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

C2 - 28364558

SN - 0305-7453

VL - 72

SP - 1103

EP - 1108

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

IS - 4

M1 - https://doi-org.pwlibresources.health.wa.gov.au/10.1093/jac/dkw422

ER -

Changing epidemiology of candidaemia in Australia

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