National surveillance of fungemia in Denmark (2004 to 2009)

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  • Maiken Cavling Arendrup
  • Brita Bruun
  • Jens Jørgen Christensen
  • Kurt Fuursted
  • Johansen, Helle Krogh
  • Poul Kjaeldgaard
  • Jenny Dahl Knudsen
  • Lise Kristensen
  • Jens Møller
  • Lene Nielsen
  • Flemming Schønning Rosenvinge
  • Bent Røder
  • Henrik Carl Schønheyder
  • Marianne Thomsen
  • Kjeld Truberg
A 6-year nationwide study of fungemia in Denmark was performed using data from an active fungemia surveillance program and from laboratory information systems in nonparticipating regions. A total of 2,820 episodes of fungemia were recorded. The incidence increased from 2004 to 2007 (7.7 to 9.6/100,000) and decreased slightly from 2008 to 2009 (8.7 to 8.6/100,000). The highest incidences were seen at the extremes of age (i.e., 11.3 and 37.1/100,000 for those 50 years of age. The species distribution varied significantly by both age and gender. Candida species accounted for 98% of the pathogens, and C. albicans was predominant, although the proportion decreased (64.4% to 53.2%, P <0.0001). C. glabrata ranked second, and the proportion increased (16.5% to 25.9%, P = 0.003). C. glabrata was more common in adults and females than in children and males, whereas C. tropicalis was more common in males (P = 0.020). C. krusei was a rare isolate (4.1%) except at one university hospital. Acquired resistance to amphotericin and echinocandins was rare. However, resistance to fluconazole (MIC of >4 µg/ml) occurred in C. albicans (7/1,183 [0.6%]), C. dubliniensis (2/65 [3.1%]), C. parapsilosis (5/83 [6.0%]), and C. tropicalis (7/104 [6.7%]). Overall, 70.8% of fungemia isolates were fully fluconazole susceptible, but the proportion decreased (79.7% to 68.9%, P = 0.02). The study confirmed an incidence rate of fungemia in Denmark three times higher than those in other Nordic countries and identified marked differences related to age and gender. Decreased susceptibility to fluconazole was frequent and increasing.
Original languageEnglish
JournalJournal of Clinical Microbiology
Volume49
Issue number1
Pages (from-to)325-34
Number of pages10
ISSN0095-1137
DOIs
Publication statusPublished - 1 Jan 2011

ID: 34154396