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...

Full description

Saved in:
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
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c758t-8a6d9fb979dcadcd3608d14d92f09f1180887e1910316e35958becc1c9e07e1e3
cites cdi_FETCH-LOGICAL-c758t-8a6d9fb979dcadcd3608d14d92f09f1180887e1910316e35958becc1c9e07e1e3
container_end_page e0120452
container_issue 3
container_start_page e0120452
container_title PloS one
container_volume 10
creator Cleveland, Angela Ahlquist
Harrison, Lee H
Farley, Monica M
Hollick, Rosemary
Stein, Betsy
Chiller, Tom M
Lockhart, Shawn R
Park, Benjamin J
description 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
doi_str_mv 10.1371/journal.pone.0120452
format article
fullrecord <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1667659631</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A419036376</galeid><doaj_id>oai_doaj_org_article_fc042297a1694407986d9557e2452283</doaj_id><sourcerecordid>A419036376</sourcerecordid><originalsourceid>FETCH-LOGICAL-c758t-8a6d9fb979dcadcd3608d14d92f09f1180887e1910316e35958becc1c9e07e1e3</originalsourceid><addsrcrecordid>eNqNk21rFDEQxxdRbK1-A9GAIAremYfdbOILodSnQqFgrW9DLjt7lyO32SbZaj-S39Ls3bXcSV_Ivthk5jf_SSYzRfGc4ClhNXm_9EPotJv2voMpJhSXFX1QHBLJ6IRTzB7urA-KJzEuMa6Y4PxxcUArQSkt5WHx5xMYZzvbzZHtjG2gM4B8i4zumrxbWY3yCqUFoLiwbRpB6Nce7_z8ZmRP1qxGAaKNSY8KtkPpl0eXF2gFKfjeO5sdSAfQ8R2iGIsJxYR9GGMGlyJqg1-h3veD08n6bjLTERoUh3AN1rlR82nxqNUuwrPt_6i4_PL5x8m3ydn519OT47OJqSuRJkLzRrYzWcvG6MY0jGPRkLKRtMWyJURgIWogkmBGOLBKVmIGxhAjAWc7sKPi5Ua3dz6qbZWjIpzXvJKckUycbojG66Xqg13pcKO8tmpt8GGudEjWOFCtwSWlstaEy7LEtRT5dFVVA82vRQXLWh-32YbZChoDXQra7Ynuezq7UHN_rUpWC1HhLPBmKxD81QAxqZWNBsaagR_W5xaUCSrHXK_-Qe-_3Zaa63wB27U-5zWjqDouicSMs5pnanoPlb-xM0xuydZm-17A272AzCT4neZ6iFGdXnz_f_b85z77eoddgHZpEb0bxi6K-2C5AU3wMQZo74pMsBon6rYaapwotZ2oHPZi94Hugm5HiP0Frwgbrw</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1667659631</pqid></control><display><type>article</type><title>Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008-2013: results from population-based surveillance</title><source>NCBI_PubMed Central（免费）</source><source>Publicly Available Content Database</source><creator>Cleveland, Angela Ahlquist ; Harrison, Lee H ; Farley, Monica M ; Hollick, Rosemary ; Stein, Betsy ; Chiller, Tom M ; Lockhart, Shawn R ; Park, Benjamin J</creator><contributor>Chowdhary, Anuradha</contributor><creatorcontrib>Cleveland, Angela Ahlquist ; Harrison, Lee H ; Farley, Monica M ; Hollick, Rosemary ; Stein, Betsy ; Chiller, Tom M ; Lockhart, Shawn R ; Park, Benjamin J ; Chowdhary, Anuradha</creatorcontrib><description>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&lt;0.001; MD: 30.9 to 14.4, p&lt;0.001). A total of 3,255 cases (85%) had a central venous catheter (CVC) in place within 2 days before the BSI culture date. In both locations, the number of CVC-associated cases declined (GA: 473 to 294; MD: 384 to 151). Candida albicans (CA, 36%) and Candida glabrata (CG, 27%) were the most common species recovered. In both locations, the proportion of cases with fluconazole resistance decreased (GA: 8.0% to 7.1%, -10%; MD: 6.6% to 4.9%, -25%), while the proportion of cases with an isolate resistant to an echinocandin increased (GA: 1.2% to 2.9%, +147%; MD: 2.0% to 3.5%, +77%). Most (74%) echinocandin-resistant isolates were CG; 17 (&lt;1%) isolates were resistant to both drug categories (multidrug resistant [MDR], 16/17 were CG). The proportion of CG cases with MDR Candida increased from 1.8% to 2.6%. We observed a significant decline in the incidence of candidemia over a five-year period, and increases in echinocandin-resistant and MDR Candida. Efforts to strengthen infection control practices may be preventing candidemia among high-risk patients. Further surveillance for resistant Candida is warranted.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0120452</identifier><identifier>PMID: 25822249</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2015-03, Vol.10 (3), p.e0120452-e0120452</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”) Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-8a6d9fb979dcadcd3608d14d92f09f1180887e1910316e35958becc1c9e07e1e3</citedby><cites>FETCH-LOGICAL-c758t-8a6d9fb979dcadcd3608d14d92f09f1180887e1910316e35958becc1c9e07e1e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1667659631/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1667659631?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,36992,44569,53769,53771,74872</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25822249$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Chowdhary, Anuradha</contributor><creatorcontrib>Cleveland, Angela Ahlquist</creatorcontrib><creatorcontrib>Harrison, Lee H</creatorcontrib><creatorcontrib>Farley, Monica M</creatorcontrib><creatorcontrib>Hollick, Rosemary</creatorcontrib><creatorcontrib>Stein, Betsy</creatorcontrib><creatorcontrib>Chiller, Tom M</creatorcontrib><creatorcontrib>Lockhart, Shawn R</creatorcontrib><creatorcontrib>Park, Benjamin J</creatorcontrib><title>Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008-2013: results from population-based surveillance</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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&lt;0.001; MD: 30.9 to 14.4, p&lt;0.001). A total of 3,255 cases (85%) had a central venous catheter (CVC) in place within 2 days before the BSI culture date. In both locations, the number of CVC-associated cases declined (GA: 473 to 294; MD: 384 to 151). Candida albicans (CA, 36%) and Candida glabrata (CG, 27%) were the most common species recovered. In both locations, the proportion of cases with fluconazole resistance decreased (GA: 8.0% to 7.1%, -10%; MD: 6.6% to 4.9%, -25%), while the proportion of cases with an isolate resistant to an echinocandin increased (GA: 1.2% to 2.9%, +147%; MD: 2.0% to 3.5%, +77%). Most (74%) echinocandin-resistant isolates were CG; 17 (&lt;1%) isolates were resistant to both drug categories (multidrug resistant [MDR], 16/17 were CG). The proportion of CG cases with MDR Candida increased from 1.8% to 2.6%. We observed a significant decline in the incidence of candidemia over a five-year period, and increases in echinocandin-resistant and MDR Candida. Efforts to strengthen infection control practices may be preventing candidemia among high-risk patients. Further surveillance for resistant Candida is warranted.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antifungal agents</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Bacterial infections</subject><subject>Baltimore - epidemiology</subject><subject>Candida</subject><subject>Candida - drug effects</subject><subject>Candida glabrata</subject><subject>Candidemia</subject><subject>Candidemia - drug therapy</subject><subject>Candidemia - epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Comparative analysis</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Drug resistance</subject><subject>Drug Resistance, Fungal - drug effects</subject><subject>Echinocandins</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Fluconazole</subject><subject>Fungicides</subject><subject>Georgia - epidemiology</subject><subject>Health aspects</subject><subject>Health surveillance</subject><subject>Human subjects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infection</subject><subject>Infections</subject><subject>Male</subject><subject>Medical instruments</subject><subject>Medical laboratories</subject><subject>Medicine</subject><subject>Metropolitan areas</subject><subject>Microbial Sensitivity Tests</subject><subject>Middle Aged</subject><subject>Multidrug resistance</subject><subject>Mutation</subject><subject>Population</subject><subject>Population Surveillance</subject><subject>Public health</subject><subject>Risk groups</subject><subject>Surveillance</subject><subject>Trends</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNk21rFDEQxxdRbK1-A9GAIAremYfdbOILodSnQqFgrW9DLjt7lyO32SbZaj-S39Ls3bXcSV_Ivthk5jf_SSYzRfGc4ClhNXm_9EPotJv2voMpJhSXFX1QHBLJ6IRTzB7urA-KJzEuMa6Y4PxxcUArQSkt5WHx5xMYZzvbzZHtjG2gM4B8i4zumrxbWY3yCqUFoLiwbRpB6Nce7_z8ZmRP1qxGAaKNSY8KtkPpl0eXF2gFKfjeO5sdSAfQ8R2iGIsJxYR9GGMGlyJqg1-h3veD08n6bjLTERoUh3AN1rlR82nxqNUuwrPt_6i4_PL5x8m3ydn519OT47OJqSuRJkLzRrYzWcvG6MY0jGPRkLKRtMWyJURgIWogkmBGOLBKVmIGxhAjAWc7sKPi5Ua3dz6qbZWjIpzXvJKckUycbojG66Xqg13pcKO8tmpt8GGudEjWOFCtwSWlstaEy7LEtRT5dFVVA82vRQXLWh-32YbZChoDXQra7Ynuezq7UHN_rUpWC1HhLPBmKxD81QAxqZWNBsaagR_W5xaUCSrHXK_-Qe-_3Zaa63wB27U-5zWjqDouicSMs5pnanoPlb-xM0xuydZm-17A272AzCT4neZ6iFGdXnz_f_b85z77eoddgHZpEb0bxi6K-2C5AU3wMQZo74pMsBon6rYaapwotZ2oHPZi94Hugm5HiP0Frwgbrw</recordid><startdate>20150330</startdate><enddate>20150330</enddate><creator>Cleveland, Angela Ahlquist</creator><creator>Harrison, Lee H</creator><creator>Farley, Monica M</creator><creator>Hollick, Rosemary</creator><creator>Stein, Betsy</creator><creator>Chiller, Tom M</creator><creator>Lockhart, Shawn R</creator><creator>Park, Benjamin J</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150330</creationdate><title>Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008-2013: results from population-based surveillance</title><author>Cleveland, Angela Ahlquist ; Harrison, Lee H ; Farley, Monica M ; Hollick, Rosemary ; Stein, Betsy ; Chiller, Tom M ; Lockhart, Shawn R ; Park, Benjamin J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-8a6d9fb979dcadcd3608d14d92f09f1180887e1910316e35958becc1c9e07e1e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antifungal agents</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Bacterial infections</topic><topic>Baltimore - epidemiology</topic><topic>Candida</topic><topic>Candida - drug effects</topic><topic>Candida glabrata</topic><topic>Candidemia</topic><topic>Candidemia - drug therapy</topic><topic>Candidemia - epidemiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Comparative analysis</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Drug resistance</topic><topic>Drug Resistance, Fungal - drug effects</topic><topic>Echinocandins</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Fluconazole</topic><topic>Fungicides</topic><topic>Georgia - epidemiology</topic><topic>Health aspects</topic><topic>Health surveillance</topic><topic>Human subjects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infection</topic><topic>Infections</topic><topic>Male</topic><topic>Medical instruments</topic><topic>Medical laboratories</topic><topic>Medicine</topic><topic>Metropolitan areas</topic><topic>Microbial Sensitivity Tests</topic><topic>Middle Aged</topic><topic>Multidrug resistance</topic><topic>Mutation</topic><topic>Population</topic><topic>Population Surveillance</topic><topic>Public health</topic><topic>Risk groups</topic><topic>Surveillance</topic><topic>Trends</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cleveland, Angela Ahlquist</creatorcontrib><creatorcontrib>Harrison, Lee H</creatorcontrib><creatorcontrib>Farley, Monica M</creatorcontrib><creatorcontrib>Hollick, Rosemary</creatorcontrib><creatorcontrib>Stein, Betsy</creatorcontrib><creatorcontrib>Chiller, Tom M</creatorcontrib><creatorcontrib>Lockhart, Shawn R</creatorcontrib><creatorcontrib>Park, Benjamin J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Science in Context</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological &amp; Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest_Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science &amp; Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Advanced Technologies &amp; Aerospace Collection</collection><collection>Agricultural &amp; Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>Biological Sciences</collection><collection>Agriculture Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest advanced technologies &amp; aerospace journals</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cleveland, Angela Ahlquist</au><au>Harrison, Lee H</au><au>Farley, Monica M</au><au>Hollick, Rosemary</au><au>Stein, Betsy</au><au>Chiller, Tom M</au><au>Lockhart, Shawn R</au><au>Park, Benjamin J</au><au>Chowdhary, Anuradha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008-2013: results from population-based surveillance</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-03-30</date><risdate>2015</risdate><volume>10</volume><issue>3</issue><spage>e0120452</spage><epage>e0120452</epage><pages>e0120452-e0120452</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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&lt;0.001; MD: 30.9 to 14.4, p&lt;0.001). A total of 3,255 cases (85%) had a central venous catheter (CVC) in place within 2 days before the BSI culture date. In both locations, the number of CVC-associated cases declined (GA: 473 to 294; MD: 384 to 151). Candida albicans (CA, 36%) and Candida glabrata (CG, 27%) were the most common species recovered. In both locations, the proportion of cases with fluconazole resistance decreased (GA: 8.0% to 7.1%, -10%; MD: 6.6% to 4.9%, -25%), while the proportion of cases with an isolate resistant to an echinocandin increased (GA: 1.2% to 2.9%, +147%; MD: 2.0% to 3.5%, +77%). Most (74%) echinocandin-resistant isolates were CG; 17 (&lt;1%) isolates were resistant to both drug categories (multidrug resistant [MDR], 16/17 were CG). The proportion of CG cases with MDR Candida increased from 1.8% to 2.6%. We observed a significant decline in the incidence of candidemia over a five-year period, and increases in echinocandin-resistant and MDR Candida. Efforts to strengthen infection control practices may be preventing candidemia among high-risk patients. Further surveillance for resistant Candida is warranted.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25822249</pmid><doi>10.1371/journal.pone.0120452</doi><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1932-6203
ispartof PloS one, 2015-03, Vol.10 (3), p.e0120452-e0120452
issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_1667659631
source NCBI_PubMed Central（免费）; Publicly Available Content Database
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
title Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008-2013: results from population-based surveillance
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T22%3A13%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Declining%20incidence%20of%20candidemia%20and%20the%20shifting%20epidemiology%20of%20Candida%20resistance%20in%20two%20US%20metropolitan%20areas,%202008-2013:%20results%20from%20population-based%20surveillance&rft.jtitle=PloS%20one&rft.au=Cleveland,%20Angela%20Ahlquist&rft.date=2015-03-30&rft.volume=10&rft.issue=3&rft.spage=e0120452&rft.epage=e0120452&rft.pages=e0120452-e0120452&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0120452&rft_dat=%3Cgale_plos_%3EA419036376%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c758t-8a6d9fb979dcadcd3608d14d92f09f1180887e1910316e35958becc1c9e07e1e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1667659631&rft_id=info:pmid/25822249&rft_galeid=A419036376&rfr_iscdi=true