Author(s): Arendrup MC, Fuursted K, GahrnHansen B, Schnheyder HC, Knudsen JD,
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Abstract A semi-national laboratory-based surveillance programme for fungaemia was initiated in 2003 that now covers c. 3.5 million inhabitants (64\%) of the Danish population. In total, 1089 episodes of fungaemia were recorded during 2004-2006, corresponding to an annual incidence of 10.4/100 000 inhabitants. The annual number of episodes increased by 17\% during the study period. Candida spp. accounted for 98\% of the fungal pathogens. Although Candida albicans remained predominant, the proportion of C. albicans decreased from 66.1\% in 2004 to 53.8\% in 2006 (p <0.01), and varied considerably among participating departments, e.g., from 51.1\% at a university hospital in Copenhagen to 67.6\% in North Jutland County. Candida glabrata ranked second, and increased in proportion from 16.7\% to 22.7\% (p 0.04). Candida krusei was isolated rarely (4.1\%), but the proportion doubled during the study period from 3.2\% to 6.4\% (p 0.06). MIC distributions of amphotericin B and caspofungin were in close agreement with the patterns predicted by species identification; however, decreased susceptibility to voriconazole, defined as an MIC of >1 mg/L, was detected in one (2.5\%) C. glabrata isolate in 2004 and in 12 (14.0\%) isolates in 2006 (p 0.03). Overall, the proportion of isolates with decreased susceptibility to fluconazole exceeded 30\% in 2006. The incidence of fungaemia in Denmark was three-fold higher than that reported from other Nordic countries and is increasing. Decreased susceptibility to fluconazole is frequent, and a new trend towards C. glabrata isolates with elevated voriconazole MICs was observed.
This article was published in Clin Microbiol Infect
and referenced in Fungal Genomics & Biology