CAND-LO 2014-15 study: changing epidemiology of candidemia in Lombardy (Italy)

被引：22

作者：

Prigitano, Anna ^{[1
]}

Cavanna, Caterina ^{[2
]}

Passera, Marco ^{[3
]}

Ossi, Cristina ^{[4
]}

Sala, Eugenio ^{[5
]}

Lombardi, Gianluigi ^{[6
]}

Grancini, Anna ^{[7
]}

De Luca, Concetta ^{[8
]}

Bramati, Simone ^{[9
]}

Gelmi, Marina ^{[10
]}

Tejada, Milvana ^{[11
]}

Grande, Romualdo ^{[12
]}

Farina, Claudio ^{[3
]}

Lallitto, Fabiola ^{[2
]}

Tortorano, Anna Maria ^{[1
]}

机构：

[1] Univ Milan, Dept Biomed Sci Hlth, Milan, Italy

[2] IRCCS San Matteo Hosp Fdn, Microbiol & Virol Unit, Pavia, Italy

[3] ASST Papa Giovanni XXIII, Inst Microbiol, Bergamo, Italy

[4] Osped San Raffaele, Lab Med Serv, Milan, Italy

[5] ASST Lariana, UOS Microbiol, Como, Italy

[6] Osped Niguarda Ca Granda, Microbiol Lab, Milan, Italy

[7] IRCCS Fdn, UOS Microbiol, Cent Lab, Ca Granda Osped Maggiore Policlin, Milan, Italy

[8] IRCCS Humanitas Res Hosp, Microbiol Sect, Anal Labs, Rozzano, Italy

[9] Osped San Gerardo, Microbiol Lab, Monza, Italy

[10] ASST Spedali Civili Brescia, Microbiol & Virol Unit, Brescia, Italy

[11] IRCCS Policlin San Donato, San Donato Milanese, Italy

[12] Bioemergencies ASST FBF Sacco Osped L Sacco, UOC Clin Microbiol Virol & Diagnost, Milan, Italy

来源：

INFECTION | 2016年 / 44卷 / 06期

关键词：

Candidemia; Candida bloodstream infection; Italy; Candida; SPECIES DISTRIBUTION; SUSCEPTIBILITY; CANDIDAEMIA; SPP;

D O I：

10.1007/s15010-016-0951-6

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Purpose The aim of this study was to monitor recent changes in the epidemiology of candidemia and in the antifungal susceptibility profiles of Candida isolates in one Italian region (Lombardy) in 2014-2015 in comparison with two other studies performed in the same area in 1997-1999 and in 2009. Methods A laboratory-based surveillance was conducted in 11 microbiology laboratories. Identification of Candida isolates from 868 episodes and antifungal susceptibility testing (YeastOne) was performed locally. Results A progressive increase in the rate of candidemia up to 1.27/1000 admissions and 1.59/10,000 patient days was documented. In all the three surveys, Candida albicans remains the most frequently isolated species, ranging from 52 to 59 % of the etiology of BSIs. The epidemiological shift to the more resistant C. glabrata, observed between 1997-1999 and 2009 surveys, was not confirmed by our more recent data. The pattern of etiology of BSIs occurred in 2014-2015 overlaps that of the 90s. Acquired antifungal resistance is a rare event. No isolate had an amphoterin B minimal inhibitory concentration (MIC, mg/L) value higher than the epidemiological cutoff. All the echinocandin MIC distributions are typical for wild-type organisms except for those of two C. glabrata isolates. Fluconazole resistance declined from 24.9 % in the 2009 survey to 5.4 % in the recent one. Conclusions Data from regional surveys may highlight the influence of therapeutic practices on the epidemiology of Candida BSIs and may optimize empirical therapies.

引用

页码：765 / 780

页数：16