Epidemiology and antifungal susceptibility patterns of candidemia from a tertiary centre in Western Australia

Abstract

Candidemia is a common invasive fungal infection with a high mortality rate. We performed a retrospective audit of candidemia at a tertiary centre in Western Australia, 2005–2014. There were 167 episodes of candidemia due to 173 isolates of Candida. Candida albicans (40.5%), Candida glabrata complex (30.6%), Candida parapsilosis complex (14.4%) were the most common species causing candidemia across the study. Of the tested isolates, 17.7% (11/62) were non-susceptible to fluconazole and 13.6% (9/66) non-susceptible to caspofungin. 22.8% (8/35) C. glabrata complex were fluconazole resistant and 17.1% (6/35) were non-susceptible to caspofungin. Candida glabrata complex was more common in the latter time period, but there were no susceptibility changes over time. In our setting, the prevalence of C. glabrata complex and antifungal non-susceptibility is high, and the prevalence of C. glabrata complex is increasing.

Keywords:

• Candidemia
• candida epidemiology
• antifungal resistance
• Candida glabrata complex
• fluconazole
• echinocandin
• Australia

Acknowledgements

Thanks to the staff of the Fiona Stanley Hospital mycology division of PathWest Laboratory Medicine WA who performed the testing.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Peter Boan is an infectious diseases physician and microbiologist at Fiona Stanley Hospital and PathWest Laboratory Medicine WA, specialising in the management of transplant and other immunocompromised patients.

Dianne Gardam is the chief mycology scientist at the department of microbiology of PathWest Laboratory Medicine WA at Fiona Stanley Hospital.