title: Current trends in candidemia and species distribution among adults: Candida glabrata surpasses C. albicans in diabetic patients and abdominal sources.
abstract: Candidemia rate and species distribution vary according to the type of patients, country of origin and antifungal prophylaxis use. To present current candidemia epidemiological trends. A retrospective examination of candidemia in adults (≥18 years-old) hospitalised from 2007 to 2015. Cases were identified through the microbiology laboratory. Candida species were distinguished based on colony morphology and VITEK-2 YBC cards, (bioMerieux, Durham, NC, USA). Patient characteristics, species distribution, source and outcome were assessed. We encountered 275 patients (294 episodes) with candidemia. The rate of candidemia dropped in 2010 (P = 0.003) without further decline. Nearly all cases (97.5%) were healthcare-associated. C. albicans (n = 118) and C. glabrata (n = 77) proportions varied without a discernable trend. C. glabrata was more common in diabetics [52.9% vs. 32.0% (non-diabetics); P = 0.004] and abdominal sources [53.3% vs. 35.5% (other sources); P = 0.03], especially gastric/duodenal foci [88.9% vs. 44.1% (other abdominal foci); P = 0.02]. All-cause 30-day mortality rate was 43.3% without changes over time or differences between C. albicans and C. glabrata. In conclusion, the candidemia rate remains stable after a decline in 2010. C. albicans remains the most common species but C. glabrata predominates in diabetics and abdominal sources. These findings suggest possible species-related differences in colonisation dynamics or pathogenicity.
authors.affiliation: Department of Medicine, St. John Hospital & Medical Center, Grosse Pointe Woods, MI, USA.
authors.forename: Riad
authors.initials: R
authors.lastname: Khatib
authors.affiliation: Department of Medicine, St. John Hospital & Medical Center, Grosse Pointe Woods, MI, USA.
authors.forename: Leonard B
authors.initials: LB
authors.lastname: Johnson
authors.affiliation: Department of Medicine, St. John Hospital & Medical Center, Grosse Pointe Woods, MI, USA.
authors.forename: Mohamad G
authors.initials: MG
authors.lastname: Fakih
authors.affiliation: Department of Medical Education, St. John Hospital & Medical Center, Grosse Pointe Woods, MI, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Riederer
authors.affiliation: Department of Pathology, St. John Hospital & Medical Center, Grosse Pointe Woods, MI, USA.
authors.forename: Laurence
authors.initials: L
authors.lastname: Briski
mesh_terms: D000005:Abdomen / Q000382:microbiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002176:Candida albicans / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D041221:Candida glabrata / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D058387:Candidemia / Q000097:blood / Q000382:microbiology* / Q000401:mortality; D048909:Diabetes Complications / Q000097:blood / Q000382:microbiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: 
  Candida albicans
  ; Candida glabrata; Candidemia; trend