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J Med Microbiol 56 (2007), 1066-1075; DOI: 10.1099/jmm.0.47239-0
© 2007 Society for General Microbiology
ISSN 1473-5644

One year prospective survey of Candida bloodstream infections in Scotland

Frank C. Odds1, Mary F. Hanson2, Amanda D. Davidson1, Mette D. Jacobsen1, Pauline Wright3, Julie A. Whyte1, Neil A. R. Gow1 and Brian L. Jones3

1 Aberdeen Fungal Group, School of Medical Sciences, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK

2 Department of Medical Microbiology, Western General Hospital, Edinburgh EH4 10XU, UK

3 Department of Medical Microbiology, Royal Infirmary, Glasgow G4 OSF, UK

Correspondence
Frank C. Odds
f.odds{at}abdn.ac.uk

Received 19 February 2007
Accepted 13 April 2007

A 12 month survey of candidaemia in Scotland, UK, in which every Scottish hospital laboratory submitted all blood isolates of yeasts for identification, strain typing and susceptibility testing, provided 300 isolates from 242 patients, generating incidence data of 4.8 cases per 100 000 population per year and 5.9 cases per 100 000 acute occupied bed days; 27.9 % of cases occurred in intensive care units. More than half the patients with candidaemia had an underlying disease involving the abdomen, 78 % had an indwelling intravenous catheter, 62 % had suffered a bacterial infection within the 2 weeks prior to candidaemia and 37 % had undergone a laparotomy. Candida albicans was the infecting species in 50 % of cases, followed by Candida glabrata (21 %) and Candida parapsilosis (12 %). Seven cases of candidaemia were caused by Candida dubliniensis, which was more prevalent even than Candida lusitaniae and Candida tropicalis (six cases each). Among C. glabrata isolates, 55 % showed reduced susceptibility to fluconazole, but azole resistance among other species was extremely low. Multilocus sequence typing showed isolates with high similarity came from different hospitals across the country, and many different types came from the hospitals that submitted the most isolates, indicating no tendency towards hospital-specific endemic strains. Multiple isolates of C. albicans and C. glabrata from individual patients were of the same strain type with single exceptions for each species. The high prevalence of candidaemia in Scotland, relative to other population-based European studies, and the high level of reduced fluconazole susceptibility of Scottish C. glabrata isolates warrant continued future surveillance of invasive Candida infections.

Abbreviations: AOBD, acute occupied bed day; DST, diploid sequence type; ICU, intensive care unit; IV, intravenous; MLST, multilocus sequence typing; OBD, occupied bed day; PMN, polymorphonuclear neutrophil; S-DD, susceptible dose-dependent; ST, sequence type.




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