Changing epidemiology of candidaemia in Australia

Belinda Chapman, Monica Slavin, Debbie Marriott, Catriona L Halliday, Sarah E Kidd, Ian H 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 J. Leung, Nenad Macesic, Jeannie BotesChristopher Blyth, Louise A Cooley, C. Robert George, Pankaja Kalukottege, Alison Kesson, Brendan Joseph McMullan, Robert W 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

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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
Issue number4
Publication statusPublished - 1 Apr 2017

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