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A Prospective Surveillance Study of Candidaemia: Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients

This study provide an up-to-date overview of the epidemiology and risk factors for Candida bloodstream infection in Scotland in 2012/2013, and the antifungal susceptibility of isolates from blood cultures from 11 National Health Service boards within Scotland. Candida isolates were identified by chr...

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Autores principales: Rajendran, Ranjith, Sherry, Leighann, Deshpande, Ashutosh, Johnson, Elizabeth M., Hanson, Mary F., Williams, Craig, Munro, Carol A., Jones, Brian L., Ramage, Gordon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910670/
https://www.ncbi.nlm.nih.gov/pubmed/27379047
http://dx.doi.org/10.3389/fmicb.2016.00915
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author Rajendran, Ranjith
Sherry, Leighann
Deshpande, Ashutosh
Johnson, Elizabeth M.
Hanson, Mary F.
Williams, Craig
Munro, Carol A.
Jones, Brian L.
Ramage, Gordon
author_facet Rajendran, Ranjith
Sherry, Leighann
Deshpande, Ashutosh
Johnson, Elizabeth M.
Hanson, Mary F.
Williams, Craig
Munro, Carol A.
Jones, Brian L.
Ramage, Gordon
author_sort Rajendran, Ranjith
collection PubMed
description This study provide an up-to-date overview of the epidemiology and risk factors for Candida bloodstream infection in Scotland in 2012/2013, and the antifungal susceptibility of isolates from blood cultures from 11 National Health Service boards within Scotland. Candida isolates were identified by chromogenic agar and confirmed by MALDI–TOF methods. Survival and associated risk factors for patients stratified as albicans and non-albicans cases were assessed. Information on the spectrum of antifungals used was collected and summarized. The isolates sensitivity to different antifungals was tested by broth microdilution method and interpreted according to CLSI/EUCAST guidelines. Forty one percent of candidaemia cases were associated with Candida albicans, followed by C. glabrata (35%), C. parapsilosis (11.5%), and remainder with other Candida spp. C. albicans and C. glabrata infections were associated with 20.9 and 16.3% mortality, respectively. Survival of patients with C. albicans was significantly lower compared to non-C. albicans and catheter line removal in C. albicans patients significantly increases the survival days. Predisposing factors such as total parenteral nutrition, and number of days on mechanical ventilation or in intensive care, were significantly associated with C. albicans infections. Fluconazole was used extensively (64.5%) for treating candidaemia cases followed by echinocandins (33.8%). Based on CLSI breakpoints, MIC test found no resistance to any antifungals tested except 5.26% fluconazole resistance among C. glabrata isolates. Moreover, by comparing to EUCAST breakpoints we found 3.95% of C. glabrata isolates were resistant to anidulafungin. We have observed a shift in Candida spp. with an increasing isolation of C. glabrata. Delay and choice of antifungal treatment are associated with poor clinical outcomes.
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spelling pubmed-49106702016-07-04 A Prospective Surveillance Study of Candidaemia: Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients Rajendran, Ranjith Sherry, Leighann Deshpande, Ashutosh Johnson, Elizabeth M. Hanson, Mary F. Williams, Craig Munro, Carol A. Jones, Brian L. Ramage, Gordon Front Microbiol Microbiology This study provide an up-to-date overview of the epidemiology and risk factors for Candida bloodstream infection in Scotland in 2012/2013, and the antifungal susceptibility of isolates from blood cultures from 11 National Health Service boards within Scotland. Candida isolates were identified by chromogenic agar and confirmed by MALDI–TOF methods. Survival and associated risk factors for patients stratified as albicans and non-albicans cases were assessed. Information on the spectrum of antifungals used was collected and summarized. The isolates sensitivity to different antifungals was tested by broth microdilution method and interpreted according to CLSI/EUCAST guidelines. Forty one percent of candidaemia cases were associated with Candida albicans, followed by C. glabrata (35%), C. parapsilosis (11.5%), and remainder with other Candida spp. C. albicans and C. glabrata infections were associated with 20.9 and 16.3% mortality, respectively. Survival of patients with C. albicans was significantly lower compared to non-C. albicans and catheter line removal in C. albicans patients significantly increases the survival days. Predisposing factors such as total parenteral nutrition, and number of days on mechanical ventilation or in intensive care, were significantly associated with C. albicans infections. Fluconazole was used extensively (64.5%) for treating candidaemia cases followed by echinocandins (33.8%). Based on CLSI breakpoints, MIC test found no resistance to any antifungals tested except 5.26% fluconazole resistance among C. glabrata isolates. Moreover, by comparing to EUCAST breakpoints we found 3.95% of C. glabrata isolates were resistant to anidulafungin. We have observed a shift in Candida spp. with an increasing isolation of C. glabrata. Delay and choice of antifungal treatment are associated with poor clinical outcomes. Frontiers Media S.A. 2016-06-16 /pmc/articles/PMC4910670/ /pubmed/27379047 http://dx.doi.org/10.3389/fmicb.2016.00915 Text en Copyright © 2016 Rajendran, Sherry, Deshpande, Johnson, Hanson, Williams, Munro, Jones and Ramage. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Microbiology
Rajendran, Ranjith
Sherry, Leighann
Deshpande, Ashutosh
Johnson, Elizabeth M.
Hanson, Mary F.
Williams, Craig
Munro, Carol A.
Jones, Brian L.
Ramage, Gordon
A Prospective Surveillance Study of Candidaemia: Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients
title A Prospective Surveillance Study of Candidaemia: Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients
title_full A Prospective Surveillance Study of Candidaemia: Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients
title_fullStr A Prospective Surveillance Study of Candidaemia: Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients
title_full_unstemmed A Prospective Surveillance Study of Candidaemia: Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients
title_short A Prospective Surveillance Study of Candidaemia: Epidemiology, Risk Factors, Antifungal Treatment and Outcome in Hospitalized Patients
title_sort prospective surveillance study of candidaemia: epidemiology, risk factors, antifungal treatment and outcome in hospitalized patients
topic Microbiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910670/
https://www.ncbi.nlm.nih.gov/pubmed/27379047
http://dx.doi.org/10.3389/fmicb.2016.00915
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