title: Candidemia in Norway (1991 to 2003): results from a nationwide study.
abstract: A long-term, nationwide prospective candidemia study has been ongoing in Norway since 1991. All medical microbiological laboratories in the country have participated. During the period 1991 to 2003 a total of 1,393 episodes of candidemia occurred in 1,348 patients. The incidence of candidemia episodes per 100,000 inhabitants increased from approximately 2 episodes in the early 1990s to 3 episodes in 2001 to 2003. The average annual incidences varied markedly between the age groups. The incidence was high in patients aged < 1 year and in patients aged > or = 70 years. In patients > or = 80 years of age, the incidence has increased during the last 3 years from an annual average of 6.5 to 15.6 cases/100,000 inhabitants in 2003. Four Candida species (C. albicans [70%], C. glabrata [13%], C. tropicalis [7%], and C. parapsilosis [6%]) accounted for 95.5% of the isolates. The species distribution has been constant during the 13-year study period. The distribution of the most important species varied with the age of the patient. In patients < 1 year of age, the majority of episodes were caused by C. albicans (91%). The occurrence of C. glabrata increased with age. In patients > or = 80 years of age, approximately 1/3 of all episodes were due to this species. All C. albicans strains were susceptible to fluconazole. The percentage of yeast isolates with decreased susceptibility to fluconazole (MICs > or = 16 microg/ml) was 10.7% during the first period of this study (1991 to 1996) and 11.7% during the second period (1997 to 2003).
authors.affiliation: Institute of Medical Microbiology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway. per.sandven@fhi.no
authors.forename: Per
authors.initials: P
authors.lastname: Sandven
authors.forename: Lars
authors.initials: L
authors.lastname: Bevanger
authors.forename: Asbjørn
authors.initials: A
authors.lastname: Digranes
authors.forename: Hanne H
authors.initials: HH
authors.lastname: Haukland
authors.forename: Turid
authors.initials: T
authors.lastname: Mannsåker
authors.forename: Peter
authors.initials: P
authors.lastname: Gaustad
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D002176:Candida albicans / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015725:Fluconazole / Q000494:pharmacology; D016469:Fungemia / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole