title: Twenty-two years of candidaemia surveillance: results from a Norwegian national study.
abstract: Several studies have reported an increased incidence of candidaemia and a redistribution of species, with a decrease in the number of Candida albicans isolates. In Norway, a prospective, national surveillance study of candidaemia has been ongoing since 1991. Data from the period 1991-2003 have been published previously. The aim of this study was to follow up the incidence, species distribution and antifungal susceptibility of Candida species isolates from blood cultures in the period 2004-2012, and compare them with the corresponding findings from the period 1991-2003. Blood culture isolates of Candida species from all medical microbiological laboratories in Norway were identified and susceptibility tested at the Norwegian Mycological Reference Laboratory. A total of 1724 isolates were recovered from 1653 patients in the period 2004-2012. Comparison of the two periods showed that the average incidence of candidaemia episodes per 100 000 inhabitants increased from 2.4 (1991-2003) to 3.9 (2004-2012). The increase in incidence in the latter period was significantly higher in patients aged >40 years (p 0.001), and a marked increase was observed in patients aged >60 years (p < 0.001). In conclusion, the average incidence in Norway over a period of 22 years modestly increased from 2.4 to 3.9 per 100,000 inhabitants, this being mainly accounted for by candidaemia in the elderly. The species distribution was stable, and the rate of acquired resistance was low.
authors.affiliation: Department of Microbiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Research Institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: uxzhcl@ous-hf.no.
authors.forename: L
authors.initials: L
authors.lastname: Hesstvedt
authors.affiliation: Department of Microbiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: P
authors.initials: P
authors.lastname: Gaustad
authors.affiliation: Department of Microbiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: C T
authors.initials: CT
authors.lastname: Andersen
authors.affiliation: Department of Medical Microbiology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Haarr
authors.affiliation: Department of Infectious Diseases, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Hannula
authors.affiliation: Department of Microbiology, University Hospital of Northern Norway, Tromsø, Norway.
authors.forename: H H
authors.initials: HH
authors.lastname: Haukland
authors.affiliation: Department of Microbiology, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: N-O
authors.initials: NO
authors.lastname: Hermansen
authors.affiliation: Department of Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: K W
authors.initials: KW
authors.lastname: Larssen
authors.affiliation: Department of Microbiology, Haukeland University Hospital, Bergen, Norway.
authors.forename: H
authors.initials: H
authors.lastname: Mylvaganam
authors.affiliation: Department of Microbiology, Akershus University Hospital, Lørenskog, Norway.
authors.forename: T E
authors.initials: TE
authors.lastname: Ranheim
authors.affiliation: Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: P
authors.initials: P
authors.lastname: Sandven
authors.affiliation: Research Institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: I
authors.initials: I
authors.lastname: Nordøy
authors.forename: A
authors.initials: A
authors.lastname: Kanestrøm
authors.forename: C
authors.initials: C
authors.lastname: Grub
authors.forename: A
authors.initials: A
authors.lastname: Onken
authors.forename: C
authors.initials: C
authors.lastname: Thielsen
authors.forename: D
authors.initials: D
authors.lastname: Skaare
authors.forename: S
authors.initials: S
authors.lastname: Tofteland
authors.forename: L-J
authors.initials: LJ
authors.lastname: Sønsteby
authors.forename: R
authors.initials: R
authors.lastname: Hjetland
authors.forename: R
authors.initials: R
authors.lastname: Hide
authors.forename: E
authors.initials: E
authors.lastname: Vik
authors.forename: A
authors.initials: A
authors.lastname: Kümmel
authors.forename: S
authors.initials: S
authors.lastname: Åsheim
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D025141:Drug Resistance, Fungal; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: Antifungal susceptibility; candidaemia; population-based incidence; species distribution; surveillance