Epidemiology of invasive candidiasis: a persistent public health problem
- PMID: 17223626
- PMCID: PMC1797637
- DOI: 10.1128/CMR.00029-06
Epidemiology of invasive candidiasis: a persistent public health problem
Abstract
Invasive candidiasis (IC) is a leading cause of mycosis-associated mortality in the United States. We examined data from the National Center for Health Statistics and reviewed recent literature in order to update the epidemiology of IC. IC-associated mortality has remained stable, at approximately 0.4 deaths per 100,000 population, since 1997, while mortality associated with invasive aspergillosis has continued to decline. Candida albicans remains the predominant cause of IC, accounting for over half of all cases, but Candida glabrata has emerged as the second most common cause of IC in the United States, and several less common Candida species may be emerging, some of which can exhibit resistance to triazoles and/or amphotericin B. Crude and attributable rates of mortality due to IC remain unacceptably high and unchanged for the past 2 decades. Nonpharmacologic preventive strategies should be emphasized, including hand hygiene; appropriate use, placement, and care of central venous catheters; and prudent use of antimicrobial therapy. Given that delays in appropriate antifungal therapy are associated with increased mortality, improved use of early empirical, preemptive, and prophylactic therapies should also help reduce IC-associated mortality. Several studies have now identified important variables that can be used to predict risk of IC and to help guide preventive strategies such as antifungal prophylaxis and early empirical therapy. However, improved non-culture-based diagnostics are needed to expand the potential for preemptive (or early directed) therapy. Further research to improve diagnostic, preventive, and therapeutic strategies is necessary to reduce the considerable morbidity and mortality associated with IC.
Figures



References
-
- Abi-Said, D., E. Anaissie, O. Uzun, I. Raad, H. Pinzcowski, and S. Vartivarian. 1997. The epidemiology of hematogenous candidiasis caused by different Candida species. Clin. Infect. Dis. 24:1122-1128. - PubMed
-
- Ables, A. Z., N. A. Blumer, G. T. Valainis, M. T. Godenick, D. K. Kajdasz, and Y. Y. Palesch. 2000. Fluconazole prophylaxis of severe Candida infections in trauma and postsurgical patients: a prospective, double-blind, randomized, placebo-controlled trial. Infect. Dis. Clin. Pract. 9:169-175.
-
- Alexander, B. D., W. A. Schell, J. L. Miller, G. D. Long, and J. R. Perfect. 2005. Candida glabrata fungemia in transplant patients receiving voriconazole after fluconazole. Transplantation 80:868-871. - PubMed
-
- Alexander, B. D., and M. A. Pfaller. 2006. Contemporary tools for the diagnosis and management of invasive mycoses. Clin. Infect. Dis. 43:S15-S27.
-
- Almirante, B., D. Rodriguez, B. J. Park, M. Cuenca-Estrella, A. M. Planes, M. Almela, J. Mensa, F. Sanchez, J. Ayats, M. Gimenez, P. Sabolls, S. K. Fridkin, J. Morgan, J. L. Rodriguez-Tudela, D. W. Warnock, A. Pahissa, and the Barcelona Candidemia Project Study Group. 2005. Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from population-based surveillance, Barcelona, Spain, from 2002 to 2003. J. Clin. Microbiol. 43:1829-1835. - PMC - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous