Περίληψη:
Globally, candidemia displays geographical variety in terms of
epidemiology and incidence. In that respect, a nationwide Greek study
was conducted, reporting the epidemiology of Candida bloodstream
infections and susceptibility of isolates to antifungal agents providing
evidence for empirical treatment. All microbiologically confirmed
candidemia cases in patients hospitalized in 28 Greek centres during the
period 2009-2018 were recorded. The study evaluated the incidence of
infection/100,000 inhabitants, species distribution, and antifungal
susceptibilities of isolated strains. Overall, 6057 candidemic episodes
occurred during the study period, with 3% of them being mixed
candidemias. The average annual incidence was 5.56/100,000 inhabitants,
with significant increase over the years (p = 0.0002). C. parapsilosis
species complex (SC) was the predominant causative agent (41%),
followed by C. albicans (37%), C. glabrata SC (10%), C. tropicalis
(7%), C. krusei (1%), and other rare Candida spp. (4%). C. albicans
rates decreased from 2009 to 2018 (48% to 31%) in parallel with a
doubling incidence of C. parapsilosis SC rates (28% to 49%, p <
0.0001). Resistance to amphotericin B and flucytosine was not observed.
Resistance to fluconazole was detected in 20% of C. parapsilosis SC
isolates, with a 4% of them being pan-azole-resistant. A considerable
rising rate of resistance to this agent was observed over the study
period (p < 0.0001). Echinocandin resistance was found in 3% of C.
glabrata SC isolates, with 70% of them being
pan-echinocandin-resistant. Resistance rate to this agent was stable
over the study period. This is the first multicentre nationwide study
demonstrating an increasing incidence of candidemia in Greece with a
species shift toward C. parapsilosis SC. Although the overall antifungal
resistance rates remain relatively low, fluconazole-resistant C.
parapsilosis SC raises concern.
Συγγραφείς:
Mamali, Vasiliki
Siopi, Maria
Charpantidis, Stefanos and
Samonis, George
Tsakris, Athanasios
Vrioni, Georgia and
Candi-Candi Network
