Chapman, Belinda

Slavin, Monica

Marriott, Debbie

Halliday, Catriona

Kidd, Sarah

Arthur, Ian

Bak, Narin

Heath, Christopher H

Kennedy, Karina

Morrissey, C Orla

Sorrell, Tania C

van Hal, Sebastian

Keighley, Caitlin

Goeman, Emma

Underwood, Neil

Hajkowicz, Krispin

Hofmeyr, Ann

Leung, Michael

Macesic, Nenad

Botes, Jeannie

Blyth, Christopher

Cooley, Louise

George, C Robert

Kalukottege, Pankaja

Kesson, Alison

McMullan, Brendan

Baird, Robert

Robson, Jennifer

Korman, Tony M

Pendle, Stella

Weeks, Kerry

Liu, Eunice

Cheong, Elaine

Chen, Sharon

2017-04-01

Knowledge of contemporary epidemiology of candidaemia is essential. We aimed to identify changes since 2004 in incidence, species epidemiology and antifungal susceptibilities of Candida spp. causing candidaemia in Australia.These data were collected from nationwide active laboratory-based surveillance for candidaemia over 1 year (within 2014-2015). Isolate identification was by MALDI-TOF MS supplemented by DNA sequencing. Antifungal susceptibility testing was performed using Sensititre YeastOne™.A total of 527 candidaemia episodes (yielding 548 isolates) were evaluable. The mean annual incidence was 2.41/105 population. The median patient age was 63 years (56% of cases occurred in males). Of 498 isolates with confirmed species identity, Candida albicans was the most common (44.4%) followed by Candida glabrata complex (26.7%) and Candida parapsilosis complex (16.5%). Uncommon Candida species comprised 25 (5%) isolates. Overall, C. albicans (>99%) and C. parapsilosis (98.8%) were fluconazole susceptible. However, 16.7% (4 of 24) of Candida tropicalis were fluconazole- and voriconazole-resistant and were non-WT to posaconazole. Of C. glabrata isolates, 6.8% were resistant/non-WT to azoles; only one isolate was classed as resistant to caspofungin (MIC of 0.5 mg/L) by CLSI criteria, but was micafungin and anidulafungin susceptible. There was no azole/echinocandin co-resistance.We report an almost 1.7-fold proportional increase in C. glabrata candidaemia (26.7% versus 16% in 2004) in Australia. Antifungal resistance was generally uncommon, but azole resistance (16.7% of isolates) amongst C. tropicalis may be emerging.

Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.

Department of Infectious Diseases, Peter MacCallum Cancer Centre, Victorian Infectious Diseases Service at the Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.

Department of Microbiology and Infectious Diseases, St Vincent's Hospital, Sydney, NSW, Australia.

Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, Westmead Hospital, Westmead, Sydney, NSW, Australia.

National Mycology Reference Centre, SA Pathology, Adelaide, SA, Australia.

Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia.

Department of Infectious Diseases, Royal Adelaide Hospital, Adelaide, SA, Australia.

Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Department of Microbiology, PathWest Laboratory Medicine Fiona Stanley Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.

Department of Infectious Diseases and Microbiology, Canberra Hospital, Australian National University Medical School, Canberra, ACT, Australia.

Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, VIC, Australia.

Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.

Centre for Infectious Diseases and Microbiology Westmead Institute for Medical Research, Westmead Hospital and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia.

Department of Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

Centre for Infectious Diseases and Microbiology Westmead Institute for Medical Research, Westmead Hospital and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia.

Department of Microbiology and Infectious Diseases, St Vincent's Hospital, Sydney, NSW, Australia.

Infection Management Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Department of Infectious Diseases, Royal Brisbane and Women's Hospital, School of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Department of Microbiology and Infectious Diseases, Liverpool Hospital, Sydney, NSW, Australia.

Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia.

Department of Infectious Diseases, Austin Hospital, Heidelberg, VIC, Australia and Division of Infectious Diseases, Columbia University Medical Center, New York City, NY, USA.

Department of Microbiology, SEALS South Pathology, Wollongong Hospital, Wollongong, NSW, Australia.

School of Paediatrics and Child Health, University of Western Australia, Subiaco, WA, Australia and Department of Infectious Diseases, Princess Margaret Hospital, Subiaco, WA, Australia.

Department of Microbiology and Infectious Diseases, Royal Hobart Hospital, Hobart, Tasmania, Australia.

Department of Microbiology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, NSW, Australia.

Department of Microbiology, Pathology -North, Hunter, Newcastle, NSW, Australia.

Department of Infectious Diseases and Microbiology, The Children's Hospital, Westmead and Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia.

Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia.

Department of Microbiology, Royal Darwin Hospital, Darwin, NT, Australia.

Sullivan and Nicolaides Pathology, Brisbane, Queensland, Australia.

Monash Infectious Diseases, Monash University and Monash Health, Melbourne, VIC, Australia.

Department of Microbiology, Australian Clinical Laboratories, Sydney, NSW, Australia.

Department of Microbiology, Pathology North, Royal North Shore Hospital, Sydney, NSW, Australia.

Department of Microbiology and Infectious Diseases, Concord Hospital, Sydney, NSW, Australia.

Department of Microbiology and Infectious Diseases, Concord Hospital, Sydney, NSW, Australia.

Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, Westmead Hospital, Westmead, Sydney, NSW, Australia.

Centre for Infectious Diseases and Microbiology Westmead Institute for Medical Research, Westmead Hospital and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia.

J Antimicrob Chemother . 2017 Apr 1;72(4):1103-1108. doi: 10.1093/jac/dkw422.

1460-2091

https://pubmed.ncbi.nlm.nih.gov/28364558/?otool=iaurydwlib

https://hdl.handle.net/10137/13837

Anidulafungin

Antifungal Agents

Australia

Azoles

Candida

Candida glabrata

Candida tropicalis

Candidemia

Caspofungin

Drug Resistance, Fungal

Echinocandins

Female

Fluconazole

Humans

Incidence

Lipopeptides

Male

Micafungin

Microbial Sensitivity Tests

Sequence Analysis, DNA

Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Triazoles

Voriconazole

Changing epidemiology of candidaemia in Australia.

Journal Article

Publication