Universität zu Köln

Wisplinghoff, Hilmar, Ebbers, Jenny, Geurtz, Lea, Stefanik, Danuta, Major, Yvette, Edmond, Michael B., Wenzel, Richard P. and Seifert, Harald (2014). Nosocomial bloodstream infections due to Candida spp. in the USA: species distribution, clinical features and antifungal susceptibilities. Int. J. Antimicrob. Agents, 43 (1). S. 78 - 82. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 1872-7913

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Abstract

Candida spp. are among the most frequent nosocomial pathogens, contributing significantly to morbidity and mortality. Longitudinal data on the epidemiology of Candida bloodstream infections (BSIs) are still limited. Isolates and clinical data from 1218 episodes of Candida BSI were prospectively collected from patients in 52 hospitals in the USA between 1998 and 2006. Susceptibilities to amphotericin B, flucytosine, fluconazole, posaconazole, voriconazole, anidulafungin, caspofungin and micafungin were determined for 1077 Candida isolates by the CLSI reference broth microdilution method using the recently published species-specific clinical breakpoints. Candida albicans was the most prevalent species (50.7%), followed by Candida parapsilosis (17.4%), Candida glabrata (16.7%) and Candida tropicalis (10.2%). The prevalence of non-albicans Candida spp. increased over time. Patients had a mean age of 51 years and a mean length of hospital stay prior to BSI of 22 days. The main underlying conditions were gastrointestinal (20.1%) and pulmonary (13.0%) diseases. Intravenous catheters (19.1%) and the urinary tract (8.0%) were the most frequently determined likely sources, whilst in the majority of patients (61.1%) no source could be identified. Overall mortality was 38.1%. Of the isolates studied, 0.8% of C. albicans, 100.0% of C. glabrata, 2.9% of C. parapsilosis and 4.9% of C. tropicalis were non-susceptible to fluconazole, and 0.6% of C. albicans, 5.0% of Candida krusei, 7.6% of C. parapsilosis and 9.8% of C. tropicalis were non-susceptible to voriconazole. All echinocandins showed good activity against most Candida spp., including the majority of C. parapsilosis isolates, but only 38.1% of C. glabrata tested susceptible to caspofungin. (C) 2013 Elsevier B. V. and the International Society of Chemotherapy. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wisplinghoff, Hilmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Ebbers, Jenny UNSPECIFIED UNSPECIFIED UNSPECIFIED Geurtz, Lea UNSPECIFIED UNSPECIFIED UNSPECIFIED Stefanik, Danuta UNSPECIFIED UNSPECIFIED UNSPECIFIED Major, Yvette UNSPECIFIED UNSPECIFIED UNSPECIFIED Edmond, Michael B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wenzel, Richard P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-452291
DOI:	10.1016/j.ijantimicag.2013.09.005
Journal or Publication Title:	Int. J. Antimicrob. Agents
Volume:	43
Number:	1
Page Range:	S. 78 - 82
Date:	2014
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	1872-7913
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ANTIMICROBIAL SURVEILLANCE PROGRAM; AGENTS; ALBICANS; TRENDS Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/45229