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. 2017 Apr 1;72(4):1103-1108.
doi: 10.1093/jac/dkw422.

Changing epidemiology of candidaemia in Australia

Belinda Chapman  1 , Monica Slavin  2 , Debbie Marriott  3 , Catriona Halliday  4 , Sarah Kidd  5 , Ian Arthur  6 , Narin Bak  7 , Christopher H Heath  8 , Karina Kennedy  9 , C Orla Morrissey  10 , Tania C Sorrell  1   11 , Sebastian van Hal  12 , Caitlin Keighley  11 , Emma Goeman  3 , Neil Underwood  13 , Krispin Hajkowicz  14 , Ann Hofmeyr  15 , Michael Leung  6 , Nenad Macesic  16 , Jeannie Botes  17 , Christopher Blyth  18 , Louise Cooley  19 , C Robert George  20 , Pankaja Kalukottege  21 , Alison Kesson  22 , Brendan McMullan  23 , Robert Baird  24 , Jennifer Robson  25 , Tony M Korman  26 , Stella Pendle  27 , Kerry Weeks  28 , Eunice Liu  29 , Elaine Cheong  29 , Sharon Chen  4   11 ; Australian and New Zealand Mycoses Interest Group
Affiliations

Changing epidemiology of candidaemia in Australia

Belinda Chapman et al. J Antimicrob Chemother. .

Erratum in

  • Changing epidemiology of candidaemia in Australia.
    Chapman B, Slavin M, Marriott D, Halliday C, Kidd S, Arthur I, Bak N, Heath CH, Kennedy K, Morrissey CO, Sorrell TC, van Hal S, Keighley C, Goeman E, Underwood N, Hajkowicz K, Hofmeyr A, Leung M, Macesic N, Botes J, Blyth C, Cooley L, George CR, Kalukottege P, Kesson A, McMullan B, Baird R, Robson J, Korman TM, Pendle S, Weeks K, Liu E, Cheong E, Chen S; Australian and New Zealand Mycoses Interest Group. Chapman B, et al. J Antimicrob Chemother. 2017 Apr 1;72(4):1270. doi: 10.1093/jac/dkx047. J Antimicrob Chemother. 2017. PMID: 28204502 No abstract available.

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 YeastOne™.

Results: A total of 527 candidaemia episodes (yielding 548 isolates) were evaluable. The mean annual incidence was 2.41/105 population. The median patient age was 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.

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