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Abstract

Background

The COVID-19 pandemic and the emergence of have changed the epidemiological landscape of candidaemia worldwide.

Aim

We compared the epidemiological trends of candidaemia in a Greek tertiary academic hospital before (2009–2018) and during the early COVID-19 (2020–2021) and late COVID-19/early post-pandemic (2022–2023) era.

Methods

Incidence rates, species distribution, antifungal susceptibility profile and antifungal consumption were recorded, and one-way ANOVA or Fisher’s exact test performed. Species were identified by MALDI-ToF MS, and in vitro susceptibility determined with CLSI M27-Ed4 for and the EUCAST-E.DEF 7.3.2 for other spp.

Results

In total, 370 candidaemia episodes were recorded during the COVID-19 pandemic. Infection incidence (2.0 episodes/10,000 hospital bed days before, 3.9 during the early and 5.1 during the late COVID-19 era, p < 0.0001), (0%, 9% and 33%, p < 0.0001) and fluconazole-resistant species complex (SC) (20%, 24% and 33%, p = 0.06) infections increased over time, with the latter not associated with increase in fluconazole/voriconazole consumption. A significant increase over time was observed in fluconazole-resistant isolates regardless of species (8%, 17% and 41%, p < 0.0001). Resistance to amphotericin B or echinocandins was not recorded, with the exception of a single pan-echinocandin-resistant strain.

Conclusion

Candidaemia incidence nearly tripled during the COVID-19 era, with among the major causative agents and increasing fluconazole resistance in SC. Almost half of isolates were fluconazole-resistant, underscoring the need for increased awareness and strict implementation of infection control measures.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2024-07-18
2024-11-25
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.29.2300661
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Increase in candidemia cases and emergence of fluconazole-resistant Candida parapsilosis and C. auris isolates in a tertiary care academic hospital during the COVID-19 pandemic, Greece, 2020 to 2023
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Maria+Siopi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Siopi Maria</a>, <a href="/search?value1=Panagiota-Christina+Georgiou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Georgiou Panagiota-Christina</a>, <a href="/search?value1=Paschalis+Paranos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Paranos Paschalis</a>, <a href="/search?value1=Maria-Ioanna+Beredaki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Beredaki Maria-Ioanna</a>, <a href="/search?value1=Aikaterini+Tarpatzi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tarpatzi Aikaterini</a>, <a href="/search?value1=Eleni+Kalogeropoulou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kalogeropoulou Eleni</a>, <a href="/search?value1=Sofia+Damianidou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Damianidou Sofia</a>, <a href="/search?value1=Alexandra+Vasilakopoulou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vasilakopoulou Alexandra</a>, <a href="/search?value1=Polyxeni+Karakosta&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Karakosta Polyxeni</a>, <a href="/search?value1=Spyros+Pournaras&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pournaras Spyros</a>, <a href="/search?value1=Joseph+Meletiadis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meletiadis Joseph</a></span>. Increase in candidemia cases and emergence of fluconazole-resistant Candida parapsilosis and C. auris isolates in a tertiary care academic hospital during the COVID-19 pandemic, Greece, 2020 to 2023. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(29):pii=2300661. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.29.2300661" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.29.2300661</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 21 Nov 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 04 May 2024 </span> </p>
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