Incidence of non-bloodstream invasive candidiasis increases in US
While the incidence of candidemia has remained stable in the United States, the incidence of non-bloodstream invasive candidiasis is increasing, according to a study in The Journal of Infectious Diseases.
“This is a problem because it can be harder to detect these types of infections, and they can be harder to treat,” Emily E. Ricotta, PhD, MSc, a data scientist and epidemiologist at the National Institute of Allergy and Infectious Diseases, told Healio.
“As invasive candidiasis (IC) is a problem both in the United States health care system and globally, it is important to understand the epidemiology of these infections,” Ricotta said. “The purpose of this study was to update the estimates of IC in the U.S. using a large, nationally distributed cohort of hospitalized patients with laboratory-confirmed IC.”
Ricotta and colleagues assessed data from 2009 to 2017 using a national electronic medical record database in order to calculate the incidence and trends of IC in the U.S., including non-bloodstream IC.
They found that the incidence of candidemia remained stable at 90/100,000 patients, although there were significant increases in non-bloodstream IC such as abdominal and non-abdominal sterile site IC.
According to the study, Candida albicans and Candida glabrata remained the leading cause of IC in the U.S. The researchers did not find an increase in C. glabrata infections, which other studies have shown.
“This is good news for the U.S., as C. glabrata can exhibit higher amounts of azole and echinocandin resistance than C. albicans,” Ricotta said.
The researchers found only a few isolates of Candida auris during the study. They speculated that this may be due to the still relatively low incidence of the pathogen in most of the U.S. during the study period, limited testing capacity, or because C. auris was still being misidentified.
Ricotta added that overall, a better understanding of the epidemiology of IC will help improve patient care by providing more useful information for testing and treatment of these infections.
“Non-bloodstream IC is on the rise, so it is important to look for this as a source of infection in hospitalized patients with evidence of fungal infection, and as always, be vigilant when it comes to antifungal resistance,” she concluded.