Epidemiology of candidemia in Swiss tertiary care hospitals: secular trends, 1991-2000.
Candida species are among the most common bloodstream pathogens in the United States, where the emergence of azole-resistant Candida glabrata and Candida krusei are major concerns. Recent comprehensive longitudinal data from Europe are lacking. We conducted a nationwide survey of candidemia during 1991-2000 in 17 university and university-affiliated hospitals representing 79% of all tertiary care hospital beds in Switzerland. The number of transplantations and bloodstream infections increased significantly (P<.001). A total of 1137 episodes of candidemia were observed: Candida species ranked seventh among etiologic agents (2.9% of all bloodstream isolates). The incidence of candidemia was stable over a 10-year period. C. albicans remained the predominant Candida species recovered (66%), followed by C. glabrata (15%). Candida tropicalis emerged (9%), the incidence of Candida parapsilosis decreased (1%), and recovery of C. krusei remained rare (2%). Fluconazole consumption increased significantly (P<.001). Despite increasing high-risk activities, the incidence of candidemia remained unchanged, and no shift to resistant species occurred.
Marchetti
Oscar
O
Infectious Diseases Service, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Oscar.Marchetti@chuv.hospvd.ch
Bille
Jacques
J
Fluckiger
Ursula
U
Eggimann
Philippe
P
Ruef
Christian
C
Garbino
Jorge
J
Calandra
Thierry
T
Glauser
Michel-Pierre
MP
Täuber
Martin George
MG
Pittet
Didier
D
D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003625:Data Collection; D004352:Drug Resistance, Microbial; D015725:Fluconazole / Q000627:therapeutic use; D016469:Fungemia / Q000188:drug therapy / Q000453:epidemiology*; D006785:Hospitals, University; D006801:Humans; D008137:Longitudinal Studies; D008826:Microbial Sensitivity Tests; D013557:Switzerland / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D000935:Antifungal Agents; D015725:Fluconazole