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; Pitter, Didier
February 2004
Clinical Infectious Diseases;2/1/2004, Vol. 38 Issue 3, p311
Academic Journal
Candida species are among the most common bloodstream pathogens in the United States, where the emergence of azole­resistant Candida glabrata and Candida krusei are major concerns. Recent comprehensive longitudinal data from Europe are lacking. We conducted a nationwide survey of candidemia during 1991­2000 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.


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