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Nosocomial candidemia in the Czech Republic in 2012–2015: results of a microbiological multicentre study


Authors: I. Kocmanová 1;  P. Lysková 2,3;  V. Chrenkova 4;  P. Olišarová 5;  R. Dobiáš 3,6;  H. Janouškovcová 7;  H. Soukupová 8;  N. Mallátová 9;  L. Svobodová 3;  P. Hamal 3;  M. Skružná 10;  N. Bartoníková 11
Authors place of work: Oddělení klinické mikrobiologie, FN Brno 1;  Laboratoř mykologie a TBC, odd. parazitologie, mykologie a mykobakteriologie, Zdravotní ústav se sídlem v Ústí nad Labem 2;  Ústav mikrobiologie, LF UP v Olomouci 3;  Ústav lékařské mikrobiologie, 2. LF UK a FN Motol, Praha 4;  Ústav lékařské biochemie a laboratorní diagnostiky Všeobecné fakultní nemocnice a 1. LF UK v Praze, Klinická mikrobiologie a ATB centrum 5;  Laboratoř klinické mykologie, odd. bakteriologie a mykologie, Zdravotní ústav se sídlem v Ostravě 6;  Ústav mikrobiologie, FN Plzeň 7;  Ústav lékařské mikrobiologie, 3. LF UK a FN Královské Vinohrady, Praha 8;  Pracoviště parazitologie a mykologie, Centrální laboratoře Nemocnice České Budějovice 9;  Oddělení klinické mikrobiologie, Pracoviště laboratorních metod, Institut Klinické a Experimentální Medicíny, Praha 10;  Oddělení lékařské mikrobiologie, Krajská nemocnice T. Bati ve Zlíně 11
Published in the journal: Epidemiol. Mikrobiol. Imunol. 67, 2018, č. 1, s. 3-10
Category: Původní práce

Summary

 

Background:
Candidemia is a severe and often life-threatening infection frequently occurring in critically ill patients. During the last decade, new therapeutic and prophylactic strategies influenced (at least in some patient subgroups) the epidemiological situation and the spectrum of causative Candida strains. The present multicentre study aimed to assess the current epidemiological situation of Candida strains causing invasive candidiasis (IC) in patients of tertiary care hospitals in the Czech Republic.

Material and methods:
Clinical and microbiological data on patients with bloodstream yeast isolates collected in 11 tertiary care hospitals in the Czech Republic between 2012 and 2015 were analysed. The incidence of cases and species distribution were assessed by study year, age, and specialty. Moreover, an association with the Candida colonization and presence of toxigenic strains of Clostridium difficile in stool prior to blood culture positivity was analysed. For some of the strains, minimum inhibitory concentrations (MICs) of systemic antifungals were determined using standard methods.

Results:
A total of 886 episodes of candidemia (921 yeast strains) were identified during the study period. The overall incidence per 1000 admissions was 0.40 (range 0.21–1.22 depending on the hospital). Almost half of the isolates belonged to the species Candida albicans (49.7 %), followed by Candida glabrata (15.3 %) and Candida parapsilosis (11.2 %). Non-albicans species of Candida significantly predominated in oncology wards (71.6 %) as compared to surgery (40.4 %) or internal medicine (52.0 %) departments. More than 70.0 % of patients stayed in intensive care units at the time of positive culture; in 65.0 % of patients, colonization with the same yeast species preceded blood culture positivity. In only 5.1 % of all patients, the previous presence of toxigenic strains of Clostridium difficile in stool was found. Fifty-six of the 921 yeast strains were tested for antifungal susceptibility, with an increase in MICs to azoles being observed for C. glabrata.

Conclusion:
The incidence of candidemia in the Czech Republic did not vary significantly between 2012 and 2015, and C. glabrata was the second most common yeast species after C. albicans isolated from blood.

Keywords:
epidemiology – candidemia – incidence – antifungal susceptibility testing


Zdroje

1. Wisplinghoff H, Cornely OA, Moser S, et al. Outcomes of nosocomial bloodstream infections in adult neutropenic patients: a prospective cohort and matched case-control study. Infect Control Hosp Epidemiol 2003;24(12):905–911.

2. Wisplinghoff H, Seifert H, Tallent SM, et al. Nosocomial bloodstream infections in pediatric patients in United States hospitals: epidemiology, clinical features and susceptibilities. Pediatr Infect Dis J 2003;22(8):686–691.

3. Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004;39(3):309–317.

4. Süner A, Karaoğlan I, Mete AO, et al. Assessment of bloodstream infections and risk factors in an intensive care unit. Turk J Med Sci 2015;45(6):1243–1250.

5. Berenger BM, Doucette K, Smith SW. Epidemiology and risk factors for nosocomial bloodstream infections in solid organ transplants over a 10-year period. Transpl Infect Dis 2016;18(2):183–190.

6. Colombo AL, Guimarães T, Sukienik T, et al. Prognostic factors and historical trends in the epidemiology of candidemia in critically ill patients: an analysis of five multicenter studies sequentially conducted over a 9-year period. Intensive Care Med 2014;40(10):1489–1498.

7. Lortholary O, Renaudat C, Sitbon K, et al. Worrisome trends in incidence and mortality of candidemia in intensive care units (Paris area, 2002-2010). Intensive Care Med 2014;40(9):1303–1312.

8. Bouza E, Muñoz P. Epidemiology of candidemia in intensive care units. Int J Antimicrob Agents 2008;32 Suppl 2:S87–91.

9. Garnacho-Montero J, Díaz-Martín A, Cayuela-Dominguez A. Management of invasive Candida infections in non-neutropenic critically ill patients: from prophylaxis to early therapy. Int J Antimicrob Agents 2008;32 Suppl 2:S137–141.

10. Doi AM, Pignatari AC, Edmond MB, et al. Epidemiology and Microbiologic Characterization of Nosocomial Candidemia from a Brazilian National Surveillance Program. PLoS One 2016;11(1):e0146909.

11. Russo A, Falcone M, Fantoni M, et al. Risk factors and clinical outcomes of candidaemia in patients treated for Clostridium difficile infection. Clin Microbiol Infect 2015;21(5):493.e491–494.

12. Falagas ME, Roussos N, Vardakas KZ. Relative frequency of albicans and the various non-albicans Candida spp among candidemia isolates from inpatients in various parts of the world: a systematic review. Int J Infect Dis 2010;14(11):e954–966.

13. Pfaller MA, Diekema DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol 2010;36(1):1–53.

14. Cleveland AA, Farley MM, Harrison LH, et al. Changes in incidence and antifungal drug resistance in candidemia: results from population-based laboratory surveillance in Atlanta and Baltimore, 2008–2011. Clin Infect Dis 2012;55(10):1352–1361.

15. Arendrup MC, Guinea J, Cuenca-Estrella M, et al and the Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST). 2015. EUCAST Method for the determination of broth dilution minimum Inhibitory concentrations of antifungal agents for yeasts version 7.3. (December, 2015).

16. De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 2008;46(12):1813–1821.

17. Buchta V, Kolar M, Bergerova T, et al. Výskyt potenciálně patogenních kvasinek v krvi a moči pacientů ve velkých nemocnicích v České republice. Klin Mikrobiol Inf Lék 1998; (4):10–17.

18. Hamal P, Kocmanova I, Jedlickova A, et al. Epidemiological analysis of candidemia in Czech tertiary care hospitals in 2000–2006. J Chemother 2007; 19(Suppl 3):S61–S62

19. Bassetti M, Merelli M, Ansaldi F, et al. Clinical and therapeutic aspects of candidemia: a five year single centre study. PLoS One 2015;10(5):e0127534.

20. Berdal JE, Haagensen R, Ranheim T, et al. Nosocomial candidemia; risk factors and prognosis revisited; 11 years experience from a Norwegian secondary hospital. PLoS One 2014;9(7):e103916.

21. Pfaller MA, Messer SA, Moet GJ, et al. Candida bloodstream infections: comparison of species distribution and resistance to echinocandin and azole antifungal agents in Intensive Care Unit (ICU) and non-ICU settings in the SENTRY Antimicrobial Surveillance Program (2008–2009). Int J Antimicrob Agents 2011;38(1):65–69.

22. Tan BH, Chakrabarti A, Li RY, et al. Incidence and species distribu-tion of candidaemia in Asia: a laboratory-based surveillance study. Clin Microbiol Infect 2015;21(10):946–953.

23. Arendrup MC. Epidemiology of invasive candidiasis. Curr Opin Crit Care 2010;16(5):445–452.

24. Barchiesi F, Orsetti E, Gesuita R, et al. Epidemiology, clinical characteristics, and outcome of candidemia in a tertiary referral center in Italy from 2010 to 2014. Infection 2016;44(2):205–213.

25. Aguilar G, Delgado C, Corrales I, et al. Epidemiology of invasive candidiasis in a surgical intensive care unit: an observational study. BMC Res Notes 2015;8:491.

26. Ng K, Schorr C, Reboli AC, et al. Incidence and mortality of sepsis, severe sepsis, and septic shock in intensive care unit patients with candidemia. Infect Dis (Lond) 2015;47(8):584–587.

27. Chakrabarti A, Sood P, Rudramurthy SM, et al. Incidence, characteristics and outcome of ICU-acquired candidemia in India. Intensive Care Med 2015;41(2):285–295.

28. Ma CF, Li FQ, Shi LN, et al. Surveillance study of species distribution, antifungal susceptibility and mortality of nosocomial candidemia in a tertiary care hospital in China. BMC Infect Dis 2013;13:337.

29. Steinbach WJ, Roilides E, Berman D, et al. Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates. Pediatr Infect Dis J 2012;31(12):1252–1257.

30. León C, Alvarez-Lerma F, Ruiz-Santana S, et al. Fungal colonization and/or infection in non-neutropenic critically ill patients: results of the EPCAN observational study. Eur J Clin Microbiol Infect Dis 2009;28(3):233–242.

31. León C, Ruiz-Santana S, Saavedra P, et al. A bedside scoring system („Candida score“) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med 2006;34(3):730–737.

32. Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis 2016;62(4):e1–50.

33. Pfaller MA, Messer SA, Woosley LN, et al. Echinocandin and triazole antifungal susceptibility profiles for clinical opportunistic yeast and mold isolates collected from 2010 to 2011: application of new CLSI clinical breakpoints and epidemiological cutoff values for characterization of geographic and temporal trends of antifungal resistance. J Clin Microbiol 2013;51(8):2571–2581.

Štítky
Alergologie a imunologie Dermatologie Dětská dermatologie Hygiena a epidemiologie Infekční lékařství Mikrobiologie Laboratoř

Článek vyšel v časopise

Epidemiologie, mikrobiologie, imunologie

Číslo 1

2018 Číslo 1
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