Epidemiological patterns of candidaemia: A comprehensive analysis over a decade

Area of Science:

• Medical Mycology
• Infectious Diseases
• Epidemiology

Background:

• Fungal bloodstream infections (BSI), particularly candidaemia, are rising globally.
• Accurate and timely diagnosis of fungal infections is hindered by slow growth and specialized expertise requirements.
• Polymicrobial fungal infections complicate diagnosis and treatment strategies, necessitating robust epidemiological data.

Purpose of the Study:

• To delineate the epidemiology of monomicrobial candidaemia.
• To characterize the epidemiology of polymicrobial BSI, including mixed fungaemia and mixed Candida/bacterial BSIs.

Main Methods:

• A single-centre retrospective epidemiological study was conducted.
• Data from 950,161 blood cultures collected between 2010 and 2020 were analyzed.
• Electronic health records were used to investigate monomicrobial and polymicrobial candidaemia episodes.

Main Results:

• 1334 candidaemia episodes in 1144 patients were identified from 2010-2020.
• Candida albicans was the most frequent species (57.7%), but showed a decreasing trend.
• Nakaseomyces glabrata and Candida parapsilosis complex demonstrated increasing incidence.
• Polymicrobial BSI occurred in 19.8% of episodes, with mixed Candida/bacterial BSIs in 17% and mixed fungaemia in 2.8%.

Conclusions:

• Polymicrobial growth in candidaemia is frequent, predominantly as mixed Candida/bacterial BSIs.
• Candida albicans, though most common, is decreasing, while C. parapsilosis complex and N. glabrata are increasing.
• Epidemiological insights are crucial for developing effective empirical treatment strategies against rising fungal BSI.