The epidemiology and management of candidemia in Northern Ireland during 2002-2011, including a 12-month enhanced case review

R. Spiers*, B. Smyth, Theresa Lamagni, P. Rooney, E. Dorgan, T. Wyatt, L. Geoghegan, L. Patterson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)

Abstract

In Northern Ireland there are concerns about candidaemia, with rates higher than those reported in England and Wales. Our aim was to explore the epidemiology of candidaemia during a 10 year period and the clinical management upon suspicion of cases during a one year enhanced investigation in Northern Ireland. Candidaemia reports to the Public Health Agency were validated during 2002-2011 and used to examine incidence and antifungal sensitivity trends (during 2007-2011). A clinical proforma was used to collate information for all patients with candidaemia in 2011. The majority (96%) of isolates were captured through voluntary laboratory reporting. There was a year-on-year increase in candidaemia from 2002-2011, from 80 to 131 episodes (incidence rate ratio 1.09 95% CI 1.05-1.13). Rates were highest in males under 1 year and over 75 years. 83/98 (85%) of case notes were available from candidaemia patients during 2011. The most prevalent risk factors were patients on total parenteral nutrition (26 people, 31.3%), surgery in the two months prior to the candidaemia (25 people, 30.1%), significant steroid use in the previous 3 months (24 people, 28.9%) and active neoplastic disease (23 people, 27.7%), This study confirmed an increase in candidaemia rates over time, with the observed incidence in 2011 higher than England and Wales. We identified areas for improvement around the clinical management of candidaemia. We recommend raising the awareness of guidelines for fundoscopy, echocardiography and central venous catheter removal.

Original languageEnglish
Pages (from-to)23-29
Number of pages7
JournalMedical Mycology
Volume57
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Bibliographical note

Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved.

Keywords

  • Candida
  • Candidaemia
  • Epidemiology
  • Mortality
  • Risk factors

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