Bloodstream infections caused by Candida yeasts (= candidemia) rank at the fifth place of all nosocomial infections, and have a high mortality rate. Moreover, resistance to antifungals increased over the last years, emphasising the need for a controlled use of these drugs. This project aims at evaluating the situation in Belgium by investigating candidemia in the University Hospital of Leuven, one of the largest hospitals of the country. Incidence and antifungal resistance are analysed, as well as the consumption of antifungals at the local, national and international level.
The project first analyses the evolution of candidemia incidence in the University Hospital of Leuven through the period 2004-2015: causative agents, differences among hospital units, demographics of the patients, the influence of prior antifungal exposure, etc.
Secondly, it investigates candidemia caused by Candida glabrata, a species known for its high incidence and intrinsic resistance to various antifungal drugs. In particular, the molecular mechanisms of resistance are determined together with the genetic links existing between the strains.
Finally, we study the evolution of antifungals consumption data since 2004 at the local level and at national scale in order to be compared to other European countries.
As for antibiotics, the development of resistance in pathogenic yeasts is linked to the antimicrobial consumption. This project aims therefore at highlighting how the prescription of antifungal drugs can have an impact on the incidence of candidemia and the resistance level of the pathogenic strains.
The project contributes to a better surveillance of these infections in Belgium and a better antifungal stewardship applied in our country and its centres.