title: Epidemiology of candidemia in Swiss tertiary care hospitals: secular trends, 1991-2000.
abstract: 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.
authors.affiliation: Infectious Diseases Service, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Oscar.Marchetti@chuv.hospvd.ch
authors.forename: Oscar
authors.initials: O
authors.lastname: Marchetti
authors.forename: Jacques
authors.initials: J
authors.lastname: Bille
authors.forename: Ursula
authors.initials: U
authors.lastname: Fluckiger
authors.forename: Philippe
authors.initials: P
authors.lastname: Eggimann
authors.forename: Christian
authors.initials: C
authors.lastname: Ruef
authors.forename: Jorge
authors.initials: J
authors.lastname: Garbino
authors.forename: Thierry
authors.initials: T
authors.lastname: Calandra
authors.forename: Michel-Pierre
authors.initials: MP
authors.lastname: Glauser
authors.forename: Martin George
authors.initials: MG
authors.lastname: Täuber
authors.forename: Didier
authors.initials: D
authors.lastname: Pittet
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole