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Bloodstream yeast infections: a 15-month survey
D Swinne1, N Nolard, P VAN Rooij
1Mycology Section, Scientific Institute of Public Health, Brussels, Belgium. dswinne@iph.fgov.be
Epidemiology and Infection
|January 13, 2009
Summary
This study surveyed bloodstream yeast infections in Belgian hospitals, finding Candida albicans most common. Fluconazole was the primary treatment, though resistance varied among species, particularly in Candida glabrata.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Bloodstream yeast infections (candidemia) pose significant clinical challenges.
- Understanding the epidemiology and antifungal susceptibility patterns of yeasts is crucial for effective treatment.
Purpose of the Study:
- To investigate the species distribution and antifungal susceptibility of bloodstream yeast isolates in Belgian hospitals.
- To identify common predisposing factors associated with candidemia.
Main Methods:
- A 15-month prospective survey of 412 bloodstream yeast isolates from 54 Belgian hospitals.
- Species identification and antifungal susceptibility testing (fluconazole, itraconazole, voriconazole, amphotericin B).
- Analysis of patient predisposing factors.
Main Results:
- Candida albicans was the most frequent species (47.3%), followed by Candida glabrata (25.7%).
- Common predisposing factors included antibacterial therapy, intensive care unit (ICU) hospitalization, and indwelling catheters.
- High susceptibility was observed for amphotericin B (93.5%) and voriconazole (87%), while lower susceptibility was noted for fluconazole (42.8%) and itraconazole (39.6%).
- Azole resistance was more prevalent in Candida glabrata isolates.
Conclusions:
- Candida albicans and Candida glabrata are the leading causes of candidemia in Belgium.
- While fluconazole is widely used, significant azole resistance, especially in C. glabrata, necessitates careful monitoring and consideration of alternative agents like amphotericin B and voriconazole.
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