The epidemiology of invasive candidiasis ((IC) and candidemia has been described in numerous single-center, sentinel and population-based surveys conducted throughout the world. However, the dynamic nature of trends in IC in the U.S. suggests that this issue still merits considerable attention. Despite the fact that C. albicans remains the most common species causing IC worldwide, the incidence of C. albicans bloodstream infections (BSIs) in the U.S. was found to have decreased in population-based surveys conducted in 2008-2011 versus those in 1992-1993. In its stead both C. glabrata and C. parapsilosis have emerged as important and potentially antifungal-resistant pathogens. The species-specific incidence of C. parapsilosis doubled and that of C. glabrata increased by more than four-fold between 1992-1993 and 2008-2011. Data from the SENTRY Antifungal Surveillance Program found that in the US, the frequency of C. glabrata as a cause of BSIs increased from 18% in 1992-2001 to 25% in 2001-2007, with a concomitant increase in fluconazole resistance from 9% to 14%. The emergence of co-resistance to both azole and echinocandin antifungal agents is another concern with this species of Candida. Similarly the decreased susceptibility of C. parapsilosis to the echinocandins is a concern with this species. The emergence of less-common and antifungal-resistant species such as C. guilliermondii, C. rugosa, C. haemulonii and C. auris is a further issue that has been recognized with the broader application of molecular and proteomic methods of identification. Given the importance of local and regional epidemiology in the selection of early and appropriate antifungal therapy in patients with IC, continued surveillance is warranted.
Full conference title:
Society for General Microbiology Autumn Conference 2013
- SGM 2013