Changing epidemiology of candidaemia in Australia

Belinda Chapman, Monica Slavin, Debbie Marriott, Catriona Halliday, Sarah Kidd, Ian Arthur, Narin Bak, Christopher H. Heath, Karina Kennedy, C. Orla Morrissey, Tania C. Sorrell, Sebastian van Hal, Caitlin Keighley, Emma Goeman, Neil Underwood, Krispin Hajkowicz, Ann Hofmeyr, Michael Leung, Nenad Macesic, Jeannie BotesChristopher Blyth, Louise Cooley, C. Robert George, Pankaja Kalukottege, Alison Kesson, Brendan McMullan, Robert Baird, Jennifer Robson, Tony M. Korman, Stella Pendle, Kerry Weeks, Eunice Liu, Elaine Cheong, Sharon Chen, on behalf of the Australian and New Zealand Mycoses Interest Group, M. Thomas, S. M. Bell, C. Marshall

Research output: Contribution to journalArticlepeer-review

78 Citations (Scopus)

Abstract

Objectives: Knowledge of contemporary epidemiology of candidaemia is essential.We aimed to identify changes since 2004 in incidence, species epidemiology and antifungal susceptibilities of Candida spp. causing candidaemia in Australia. Methods: These data were collected from nationwide active laboratory-based surveillance for candidaemia over 1 year (within 2014-2015). Isolate identification was by MALDI-TOF MS supplemented by DNA sequencing. Antifungal susceptibility testing was performed using Sensititre YeastOneTM. Results: A total of 527 candidaemia episodes (yielding 548 isolates) were evaluable. The mean annual incidence was 2.41/105 population. The median patient agewas 63 years (56% of cases occurred in males). Of 498 isolates with confirmed species identity, Candida albicans was the most common (44.4%) followed by Candida glabrata complex (26.7%) and Candida parapsilosis complex (16.5%). Uncommon Candida species comprised 25 (5%) isolates. Overall, C. albicans (>99%) and C. parapsilosis (98.8%) were fluconazole susceptible. However, 16.7% (4 of 24) of Candida tropicalis were fluconazole- and voriconazole-resistant and were non-WT to posaconazole. Of C. glabrata isolates, 6.8% were resistant/non-WT to azoles; only one isolate was classed as resistant to caspofungin (MIC of 0.5 mg/L) by CLSI criteria, but was micafungin and anidulafungin susceptible. There was no azole/ echinocandin co-resistance. Conclusions:We report an almost 1.7-fold proportional increase in C. glabrata candidaemia (26.7% versus 16% in 2004) in Australia. Antifungal resistance was generally uncommon, but azole resistance (16.7% of isolates) amongst C. tropicalis may be emerging.

Original languageEnglish
Pages (from-to)1103-1108
Number of pages6
JournalJournal of Antimicrobial Chemotherapy
Volume72
Issue number4
DOIs
Publication statusPublished - Apr 2017
Externally publishedYes

Keywords

  • antifungal agents
  • epidemiology
  • azoles
  • candida albicans
  • candida parapslosis
  • candida tropicalis

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