Burden of Candidemia in the United States, 2017

Abstract

Background Candidemia is a common healthcare-associated bloodstream infection with high morbidity and mortality. There are no current estimates of candidemia burden in the United States (US). Methods In 2017, the Centers for Disease Control and Prevention conducted active population-based surveillance for candidemia through the Emerging Infections Program in 45 counties in 9 states encompassing approximately 17 million persons (5% of the national population). Laboratories serving the catchment area population reported all blood cultures with Candida, and a standard case definition was applied to identify cases that occurred in surveillance area residents. Burden of cases and mortality were estimated by extrapolating surveillance area cases to national numbers using 2017 national census data. Results We identified 1226 candidemia cases across 9 surveillance sites in 2017. Based on this, we estimated that 22 660 (95% confidence interval [CI], 20 210–25 110) cases of candidemia occurred in the US in 2017. Overall estimated incidence was 7.0 cases per 100 000 persons, with highest rates in adults aged ≥ 65 years (20.1/100 000), males (7.9/100 000), and those of black race (12.3/100 000). An estimated 3380 (95% CI, 1318–5442) deaths occurred within 7 days of a positive Candida blood culture, and 5628 (95% CI, 2465–8791) deaths occurred during the hospitalization with candidemia. Conclusions Our analysis highlights the substantial burden of candidemia in the US. Because candidemia is only one form of invasive candidiasis, the true burden of invasive infections due to Candida is higher. Ongoing surveillance can support future burden estimates and help assess the impact of prevention interventions.

Epidemiology, clinical characteristics, and outcome of candidemia in critically ill patients in Germany: a single-center retrospective 10-year analysis

“…Bloodstream infections (BSI) caused by Candida spp. have become a major concern in critical care medicine due to the increasing number of immunocompromised patients [ 1 , 2 ]. Yeast-related BSI are usually healthcare-associated infections with a high mortality of up to 60% in critically ill patients [ 1 , 3 – 5 ].…”

“…patients [1,2]. Yeast-related BSI are usually healthcareassociated infections with a high mortality of up to 60% in critically ill patients [1,[3][4][5].…”

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpatients in a tertiary teaching hospital in China

“…Candidaemia is the most common fungal disease among hospitalised patients worldwide and is the fourth to tenth most common bloodstream infection (BSI) in most population-based studies [1,2]. Candidaemia is associated with significant morbidity and mortality [3]. The main risk factors for candidaemia include critical illness, a long intensive care unit (ICU) length of stay, haematologic malignant disease, solid-organ transplantation, solid-organ tumours, low birth weight in neonates and preterm infants, broad-spectrum antimicrobial agent use, central venous catheterization (CVC), total parenteral nutrition, haemodialysis, abdominal surgery, and aggressive chemotherapy [1].…”

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpaitents in a tertiary teaching hospital in China

“…Candidaemia is associated with signi cant morbidity and mortality [3]. The main risk factors for candidaemia include critical illness, a long intensive care unit (ICU) length of stay, haematologic malignant disease, solid-organ transplantation, solid-organ tumours, low birth weight in neonates and preterm infants, broad-spectrum antimicrobial agent use, central venous catheterization (CVC), total parenteral nutrition, haemodialysis, abdominal surgery, and aggressive chemotherapy [1].…”