Invasive Candidiasis Species Distribution and Trends, United States, 2009-2017

• Type of Material: Article
• Authors: Emily E Ricotta, National Institute of Allergy and Infectious Diseases, NIH, Bethesda; Yi Ling Lai, National Institute of Allergy and Infectious Diseases, NIH, Bethesda; Ahmed Babiker, Emory University; Jeffrey R Strich, National Institutes of Health, Bethesda; Sameer S Kadri, National Institutes of Health, Bethesda; Michail S Lionakis, National Institute of Allergy and Infectious Diseases, NIH, Bethesda; Rebecca D Prevots, National Institute of Allergy and Infectious Diseases, NIH, Bethesda; Jennifer Adjemian, National Institute of Allergy and Infectious Diseases, NIH, Bethesda
• Language: English
• Date: 2021-04-01
• Publisher: OXFORD UNIV PRESS INC
• Publication Version: Final Published Version
• Copyright Statement: Published by Oxford University Press for the Infectious Diseases Society of America 2020.
• License: Creative Commons Attribution 1.0 Generic
• Final Published Version (URL): http://dx.doi.org/10.1093/infdis/jiaa502
• Title of Journal or Parent Work: JOURNAL OF INFECTIOUS DISEASES
• Volume: 223
• Issue: 7
• Start Page: 1295
• End Page: 1302
• Grant/Funding Information: This work was supported in part by the Intramural Research Programs of the National Institute of Allergy and Infectious Diseases and the National Institutes of Health Clinical Center.
• Keywords: invasive candidiasis; COLLECTION; CANDIDAEMIA; Infectious Diseases; CANDIDEMIA; SURVEILLANCE; Immunology; Life Sciences & Biomedicine; MYCOSES; electronic health record; Science & Technology; hospital infections; ECHINOCANDINS; PARAPSILOSIS; Microbiology; epidemiology; CHANGING EPIDEMIOLOGY; BLOOD-STREAM INFECTIONS
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Background: Invasive candidiasis (IC) is a growing concern among US healthcare facilities. A large-scale study evaluating incidence and trends of IC in the United States by species and body site is needed to understand the distribution of infection. Methods: An electronic medical record database was used to calculate incidence and trends of IC in the United States by species and infection site from 2009 through 2017. Hospital incidence was calculated using total unique inpatient hospitalizations in hospitals reporting at least 1 Candida case as the denominator. IC incidence trends were assessed using generalized estimating equations with exchangeable correlation structure to fit Poisson regression models, controlling for changes in hospital characteristics and case mix over time. Results: Candida albicans remains the leading cause of IC in the United States, followed by Candida glabrata. The overall incidence of IC was 90/100 000 patients, which did not change significantly over time. There were no changes in incidence among C. albicans, C. glabrata, C. parapsilosis, or C. tropicalis; the incidence of other Candida spp. as a whole increased 7.2% annually. While there was no change in candidemia 2009-2017, abdominal and nonabdominal sterile site IC increased significantly. Conclusions: Nonbloodstream IC is increasing in the United States. Understanding the epidemiology of IC should facilitate improved management of infected patients.