Scientific article
Open access

Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey

Published inOpen forum infectious diseases, vol. 8, no. 10, ofab471
Publication date2021-10-01
First online date2021-09-17

Background: The increasing incidence of candidemia and emergence of drug-resistant Candida species are major concerns worldwide. Long-term surveillance studies are needed.

Methods: The Fungal Infection Network of Switzerland (FUNGINOS) conducted a 15-year (2004-2018), nationwide, epidemiological study of candidemia. Hospital-based incidence of candidemia, Candida species distribution, antifungal susceptibility, and consumption were stratified in 3 periods (2004-2008, 2009-2013, 2014-2018). Population-based incidence over the period 2009-2018 derived from the Swiss Antibiotic Resistance Surveillance System (ANRESIS).

Results: A total of 2273 Candida blood isolates were studied. Population and hospital-based annual incidence of candidemia increased from 2.96 to 4.20/100 000 inhabitants (P = .022) and 0.86 to 0.99/10 000 patient-days (P = .124), respectively. The proportion of Candida albicans decreased significantly from 60% to 53% (P = .0023), whereas Candida glabrata increased from 18% to 27% (P < .0001). Other non-albicans Candida species remained stable. Candida glabrata bloodstream infections occurred predominantly in the age group 18-40 and above 65 years. A higher proportional increase of C glabrata was recorded in wards (18% to 29%, P < .0001) versus intensive care units (19% to 24%, P = .22). According to Clinical and Laboratory Standards Institute, nonsusceptibility to fluconazole in C albicans was observed in 1% of isolates, and anidulafungin and micafungin nonsusceptibility was observed in 2% of C albicans and C glabrata. Fluconazole consumption, the most frequently used antifungal, remained stable, whereas use of mold-active triazoles and echinocandins increased significantly in the last decade (P < .0001).

Conclusions: Over the 15-year period, the incidence of candidemia increased. A species shift toward C glabrata was recently observed, concurring with increased consumption of mold-active triazoles.

  • Antifungals
  • Candida
  • Candidemia
  • Epidemiology
  • Resistance
NotePresented in part: European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), July 9–12, 2021, Vienna, Austria.
  • Merck and Sharp and Dohme -
  • Pfizer -
  • Schering-Plough -
  • Foundation for the Advancement in Medical Microbiology and Infectious Diseases -
  • Novartis -
  • Gilead Foundation -
Citation (ISO format)
ADAM, Kai-Manuel et al. Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey. In: Open forum infectious diseases, 2021, vol. 8, n° 10, p. ofab471. doi: 10.1093/ofid/ofab471
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ISSN of the journal2328-8957

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