Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008-2013: results from population-based surveillance

Recent reports have demonstrated a decline in bacterial bloodstream infections (BSIs) following adherence to central line insertion practices; however, declines have been less evident for BSIs due to Candida species. We conducted active, population-based laboratory surveillance for candidemia in met...

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Bibliographic Details
Published in:PloS one 2015-03, Vol.10 (3), p.e0120452-e0120452
Main Authors: Cleveland, Angela Ahlquist, Harrison, Lee H, Farley, Monica M, Hollick, Rosemary, Stein, Betsy, Chiller, Tom M, Lockhart, Shawn R, Park, Benjamin J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antifungal agents
Antifungal Agents - therapeutic use
Bacterial infections
Baltimore - epidemiology
Candida
Candida - drug effects
Candida glabrata
Candidemia
Candidemia - drug therapy
Candidemia - epidemiology
Child
Child, Preschool
Comparative analysis
Disease control
Disease prevention
Drug resistance
Drug Resistance, Fungal - drug effects
Echinocandins
Epidemiology
Female
Fluconazole
Fungicides
Georgia - epidemiology
Health aspects
Health surveillance
Human subjects
Humans
Incidence
Infant
Infant, Newborn
Infection
Infections
Male
Medical instruments
Medical laboratories
Medicine
Metropolitan areas
Microbial Sensitivity Tests
Middle Aged
Multidrug resistance
Mutation
Population
Population Surveillance
Public health
Risk groups
Surveillance
Trends
Young Adult
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Summary:Recent reports have demonstrated a decline in bacterial bloodstream infections (BSIs) following adherence to central line insertion practices; however, declines have been less evident for BSIs due to Candida species. We conducted active, population-based laboratory surveillance for candidemia in metropolitan Atlanta, GA and Baltimore, MD over a 5-year period. We calculated annual candidemia incidence and antifungal drug resistance rates. We identified 3,848 candidemia cases from 2008-2013. Compared with 2008, candidemia incidence per 100,000 person-years decreased significantly by 2013 in both locations (GA: 14.1 to 9.5, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0120452