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Increasing incidence of Candida parapsilosis candidemia with caspofungin usage

Graeme N Forrest1, Elizabeth Weekes, Jennifer K Johnson

  • 1Division of Infectious Diseases, Department of Medicine, University of Maryland, 20 Penn Street, Room S403B, Baltimore, MD 21201, USA. gforrest@medicine.umaryland.edu

The Journal of Infection
|December 18, 2007
PubMed
Abstract

Insights

The introduction of caspofungin correlated with increased Candida parapsilosis infections and decreased Candida tropicalis and Candida glabrata infections. This study highlights shifts in fungal epidemiology due to antifungal use.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Antimicrobial Stewardship

Background:

  • The epidemiology of Candida species causing candidemia can change over time.
  • Antifungal drug usage patterns may influence the prevalence of specific Candida species.

Purpose of the Study:

  • To investigate the impact of caspofungin introduction on the epidemiology of Candida species.
  • To analyze trends in candidemia and antifungal use over a five-year period.

Main Methods:

  • Retrospective review of 469 candidemia episodes from 2002-2006.
  • Collected data on antifungal defined daily doses.
  • Utilized regression and Pearson correlation analyses to assess relationships between antifungal use and Candida species.

Main Results:

  • A significant increase in Candida parapsilosis candidemia coincided with increased caspofungin usage.
  • A significant decline in conventional and lipid amphotericin B usage was observed.
  • Correlations found between higher caspofungin use and increased C. parapsilosis, decreased C. tropicalis, and a trend towards decreased C. glabrata.

Conclusions:

  • Increased caspofungin use is significantly correlated with a rise in C. parapsilosis candidemia.
  • A reduction in C. tropicalis candidemia was associated with caspofungin introduction.
  • A trend towards decreased C. glabrata candidemia was noted alongside increased caspofungin usage.

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