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Epidemiology of fungaemia in Sweden: A nationwide retrospective observational survey

Journal article
Authors L. Klingspor
M. Ullberg
J. Rydberg
Nahid Kondori
L. Serrander
J. Swanberg
K. Nilsson
C. J. Bengten
M. Johansson
M. Granlund
E. Tornqvist
A. Nyberg
K. Kindlund
M. Ygge
D. Kartout-Boukdir
M. Toepfer
E. Halldin
G. Kahlmeter
V. Ozenci
Published in Mycoses
Volume 61
Issue 10
Pages 777-785
ISSN 0933-7407
Publication year 2018
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 777-785
Language en
Keywords antifungal susceptibility, Candida, candidaemia, Cryptococcus, fungaemia epidemiology, fungal, escmid-asterisk guideline, candida-glabrata, echinocandin resistance, changing epidemiology, fluconazole, surveillance, management, diagnosis, risk, Dermatology, Mycology
Subject categories Clinical Medicine


ObjectivesTo identify the epidemiology and antifungal susceptibilities of Candida spp. among blood culture isolates to identify the epidemiology and antifungal susceptibilities of Candida spp. among blood culture isolates in Sweden. MethodsThe study was a retrospective, observational nationwide laboratory-based surveillance for fungaemia and fungal meningitis and was conducted from September 2015 to August 2016. ResultsIn total, 488 Candida blood culture isolates were obtained from 471 patients (58% males). Compared to our previous study, the incidence of candidaemia has increased from 4.2/100000 (2005-2006) to 4.7/100000 population/year (2015-2016). The three most common Candida spp. isolated from blood cultures were Candida albicans (54.7%), Candida glabrata (19.7%) and species in the Candida parapsilosis complex (9.4%). Candida resistance to fluconazole was 2% in C.albicans and between 0% and 100%, in non-albicans species other than C.glabrata and C.krusei. Resistance to voriconazole was rare, except for C.glabrata, C.krusei and C.tropicalis. Resistance to anidulafungin was 3.8% while no Candida isolate was resistant to amphotericin B. ConclusionsWe report an overall increase in candidaemia but a minor decrease of C.albicans while C.glabrata and C.parapsilosis remain constant over this 10-year period.

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