TY - JOUR T1 - Increasing candidemia incidence from 2004 to 2015 with a shift in epidemiology in patients pre-exposed to antifungals. JF - Mycoses Y1 - 2017 A1 - Berdieke Goemaere A1 - Pierre Becker A1 - Van Wijngaerden, Eric A1 - Maertens, Johan A1 - Spriet, Isabel A1 - Marijke Hendrickx A1 - Lagrou, Katrien KW - Antifungal Agents KW - Candida spp. KW - candidaemia KW - epidemiology KW - incidence AB -

BACKGROUND: Candidemia is an important health problem in immunocompromised patients with an epidemiology varying with region, period and patient population involved.

OBJECTIVES: The occurrence of candidemia and the associated species distribution over a 12-year period at a large tertiary care centre in Belgium were analysed. The trend in incidence in the intensive care units (ICUs) and non-ICUs was investigated as well as the influence of antifungal exposure on the species distribution.

PATIENTS/METHODS: Candidemia incidence was expressed per 10,000 patient days (PD). Epidemiological parameters and antifungal consumption data were extracted from the hospital database and delivered by the hospital pharmacy, respectively.

RESULTS: From 2004 until 2015, 865 candidemia episodes occurred in 826 patients at the University Hospitals Leuven. Candida albicans (59%) remained the most important cause of candidemia, followed by C. glabrata (22.4%) and C. parapsilosis (8%). The mean incidence in the whole hospital was 1.48 per 10,000 PD. The incidence in ICUs increased reaching up to 10.7 per 10,000 PD whereas in the non-ICUs, the incidence decreased. Prior exposure to fluconazole and echinocandins was associated with candidemia caused by less susceptible species.

CONCLUSIONS: Candidemia incidence increased in the whole hospital, driven by ICUs. Surveillance of candidemia epidemiology on a local scale is of high value to guide empirical treatment strategies. This article is protected by copyright. All rights reserved.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/29024057?dopt=Abstract M3 - 10.1111/myc.12714 ER -