Active surveillance for candidemia, Australia

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health Surveillance

Background:

• Candidemia, a serious bloodstream infection caused by Candida species, poses a significant public health challenge.
• Understanding the epidemiology of candidemia, including incidence, risk factors, and sources of infection, is crucial for effective control.

Purpose of the Study:

• To conduct population-based surveillance of candidemia in Australia.
• To determine the incidence, predisposing factors, and sources of candidemia.
• To analyze the species distribution and identify risk factors associated with mortality.

Main Methods:

• Population-based surveillance was conducted in Australia from 2001 to 2004.
• Data on 1,095 candidemia cases were collected and analyzed.
• Incidence, predisposing factors, healthcare association (inpatient, outpatient, community-acquired), Candida species, and mortality rates were assessed.

Main Results:

• The annual incidence of candidemia was 1.81/100,000 population.
• Malignancy, indwelling vascular catheters, antimicrobial use, and surgery were common predisposing factors.
• Inpatient healthcare-associated candidemia (81.5%) was most frequent, associated with sepsis, death, and prolonged hospitalization.
• Non-Candida albicans species predominated in community-acquired infections (60.5%).
• The 30-day mortality rate was 27.7% in patients aged 65 years or older.

Conclusions:

• Candidemia surveillance is essential for monitoring trends and informing public health interventions.
• Healthcare-associated candidemia is a major concern, necessitating robust infection control measures.
• The increasing role of non-albicans Candida species requires attention in diagnostic and therapeutic strategies.
• Further epidemiologic studies with standardized definitions are recommended.