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Epidemiology of Candidemia in Swiss Tertiary Care Hospitals: Secular Trends, 1991-2000

Marchetti, Oscar ; Bille, Jacques ; Fluckiger, Ursula ; Eggimann, Philippe ; Ruef, Christian ; Garbino, Jorge ; Calandra, Thierry ; Glauser, Michel-Pierre ; Täuber, Martin George ; Pittet, Didier

In: Clinical Infectious Diseases, 2004, vol. 38, no. 3, p. 311-320

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    Titre
    • Epidemiology of Candidemia in Swiss Tertiary Care Hospitals: Secular Trends, 1991-2000
    Auteur
    • Marchetti, Oscar. Infectious Diseases Service, Department of Internal Medicine, Lausanne
    • Bille, Jacques. Institute of Microbiology, Centre Hospitalier Universitaire Vaudois, Lausanne
    • Fluckiger, Ursula. Division of Infectious Diseases, Department of Internal Medicine, Kantonsspital, Basel
    • Eggimann, Philippe. Infection Control Program, University of Geneva Hospitals, Geneva
    • Ruef, Christian. Division of Infectious Diseases, Department of Internal Medicine, University of Geneva Hospitals, Geneva
    • Garbino, Jorge. Division of Infectious Diseases and Hospital Epidemiology, Department of Internal Medicine, Universitätsspital, Zürich
    • Calandra, Thierry. Infectious Diseases Service, Department of Internal Medicine, Lausanne
    • Glauser, Michel-Pierre. Infectious Diseases Service, Department of Internal Medicine, Lausanne
    • Täuber, Martin George. Institute of Infectious Diseases, Inselspital, Bern, Switzerland
    • Pittet, Didier. Infection Control Program, University of Geneva Hospitals, Geneva
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Clinical Infectious Diseases, 2004, vol. 38, no. 3, p. 311-320. The University of Chicago Press
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:304580
    Summary
    Candida species are among the most common bloodstream pathogens in the United States, where the emergence of azole-resistant Candida glabrata and Candida krusei are major concerns. Recent comprehensive longitudinal data from Europe are lacking. We conducted a nationwide survey of candidemia during 1991-2000 in 17 university and university-affiliated hospitals representing 79% of all tertiary care hospital beds in Switzerland. The number of transplantations and bloodstream infections increased significantly (P < .001). A total of 1137 episodes of candidemia were observed: Candida species ranked seventh among etiologic agents (2.9% of all bloodstream isolates). The incidence of candidemia was stable over a 10-year period. C. albicans remained the predominant Candida species recovered (66%), followed by C. glabrata (15%). Candida tropicalis emerged (9%), the incidence of Candida parapsilosis decreased (1%), and recovery of C. krusei remained rare (2%). Fluconazole consumption increased significantly (P < .001). Despite increasing high-risk activities, the incidence of candidemia remained unchanged, and no shift to resistant species occurred