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Infection

, Volume 46, Issue 4, pp 469–476 | Cite as

Evaluation of candidemia and antifungal consumption in a large tertiary care Italian hospital over a 12-year period

  • Jessica Mencarini
  • Elisabetta Mantengoli
  • Lorenzo Tofani
  • Eleonora Riccobono
  • Rossella Fornaini
  • Filippo Bartalesi
  • Giampaolo Corti
  • Alberto Farese
  • Patrizia Pecile
  • Luca Boni
  • Gian Maria Rossolini
  • Alessandro Bartoloni
Original Paper

Abstract

Purpose

An early adequate antifungal therapy based on the knowledge of local epidemiology can reduce the candidemia-attributable mortality and the length of hospitalization. We performed a retrospective study to analyze the epidemiology of candidemia and the antifungal consumption in our hospital.

Methods

We analyzed Candida spp. isolated from the blood, and their susceptibility profile from 2005 to 2016 in Careggi University Hospital, Florence, Italy. We also performed a stratified analysis by clinical setting where Candida spp. were isolated (Medical Wards, Surgery, Intensive Care Unit-ICU). Then, we retrospectively reviewed the annual consumption of antifungal agents and calculated the defined daily dosing for 10,000 hospital days.

Results

The rate of candidemia was higher in ICU than other settings and Candida albicans was the first cause of candidemia (61.2%). After adjustment for hospital days, the rate of C. albicans showed a statistically significant parabolic trend (p < 0.001), with a peak of incidence in 2010. After 2010, we observed a reduction of candidemia due to both C. albicans and non-albicans species. Between 2005 and 2015, we reported an increasing increased use of echinocandins. As far as resistance profile is concerned, only one Candida glabrata isolate was resistant to caspofungin (1.9%) and 30% of C. glabrata were resistant to fluconazole.

Conclusions

Our data describe C. albicans as the first cause of candidemia in all the studied settings and the low rate of echinocandin resistance, despite their increased use over the study period. ICU was confirmed as the setting with the highest incidence of candidemia.

Keywords

Candidemia Echinocandin Antifungal consumption Candida albicans Antifungal susceptibility 

Notes

Acknowledgements

In 2015, JM received a research fellowship from Società Italiana Malattie Infettive e Tropicali (SIMIT).

Compliance with ethical standards

Conflict of interest

JM received grant support from Gilead, MSD Italy, outside the submitted work. GMR received grants, personal fees and other from Pfizer, MSD Italy, outside the submitted work. AB received grants and personal fees from MSD Italy and Pfizer, grants from Gilead and Astellas, outside the submitted work. LT, EM, ER, RF, FB, GC, AF, PP and LB have no conflict of interest to declare.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jessica Mencarini
    • 1
  • Elisabetta Mantengoli
    • 1
  • Lorenzo Tofani
    • 2
  • Eleonora Riccobono
    • 3
  • Rossella Fornaini
    • 4
  • Filippo Bartalesi
    • 5
  • Giampaolo Corti
    • 1
    • 5
  • Alberto Farese
    • 5
  • Patrizia Pecile
    • 6
  • Luca Boni
    • 2
  • Gian Maria Rossolini
    • 3
    • 6
  • Alessandro Bartoloni
    • 1
    • 5
  1. 1.Infectious Disease Unit, Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
  2. 2.Clinical Trials Coordinating Center of Istituto Toscano TumoriAzienda Ospedaliero-Universitaria CareggiFlorenceItaly
  3. 3.Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
  4. 4.Pharmacy UnitAzienda Ospedaliero-Universitaria CareggiFlorenceItaly
  5. 5.Infectious and Tropical Diseases UnitAzienda Ospedaliero-Universitaria CareggiFlorenceItaly
  6. 6.Microbiology and Virology UnitAzienda Ospedaliero-Universitaria CareggiFlorenceItaly

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