Surveillance of Antifungal Resistance in Candidemia Fails to Inform Antifungal Stewardship in European Countries
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion Criteria and Data Extraction
2.3. Ethics
3. Results
3.1. International Surveillance Systems
3.2. National Surveillance Systems
3.3. Epidemiological Surveillance Studies
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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ANF Class | ANF Drug | C. albicans | C. glabrata | C. parapsilosis | C. tropicalis |
---|---|---|---|---|---|
Azole 1 | Fluconazole | 4 (AT; NO; ES; UK) | 4 (AT; NO; ES *; UK) | 4 (AT; NO; ES *;UK) | 2 (AT; NO) |
Itraconazole | 2 (AT; ES) | 2 (AT, ES *) | 2 (AT; ES *) | 1 (AT) | |
Posaconazole | 1 (AT) | 2 (AT; ES *) | 1 (AT) | 1 (AT) | |
Voriconazole | 4 (AT; NO; ES; UK) | 3 (AT; ES *; UK) | 4 (AT; NO; ES *;UK) | 2 (AT; NO) | |
Echinocandin | Caspofungin | 3 (AT; ES; UK) | 3 (AT; ES*;UK) | 3 (AT; ES*;UK) | 1 (AT) |
Anidulafungin | 2 (AT; NO) | 2 (AT; NO) | 2 (AT; NO) | 2 (AT; NO) | |
Micafungin | 2 (AT; NO) | 2 (AT; NO) | 2 (AT; NO) | 1 (AT) | |
Polyene | Amphotericin B | 4 (AT; NO; ES; UK) | 4 (AT; NO; ES *;UK) | 4 (AT; NO; ES *;UK) | 2 (AT; NO) |
Characteristic Data Reporting in National Reports | Austria | Italy | Norway | Spain | UK | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
CA | NAC | CA | NAC | CA | NAC | CA | NAC | CA | NAC | ||
Frequency of reporting (yearly) | -- | -- | |||||||||
Data stratification (age, sex, sub-setting) | -- | -- | -- | -- | -- | -- | |||||
Source of infection | -- | -- | -- | -- | -- | -- | |||||
No. patients | -- | -- | -- | -- | -- | -- | |||||
BSI incidence | Per 100 pt | -- | -- | -- | -- | -- | -- | -- | -- | ||
Per 100 pt/7 days OR Per 100 pt/12-day catheter | -- | -- | -- | -- | -- | -- | -- | -- | -- | ||
Candidemia incidence | Per 100,000 population | -- | -- | -- | -- | -- | -- | - | - | ||
Total Candida isolates | - | - | |||||||||
Specific-species identification CA /NAC | - | ||||||||||
Antifungal consumption | - | - | - | - | - | - | |||||
Laboratory method | NS | - | NS | - | NS | NS | |||||
S/SDD/R or non-susceptible | NS | - | |||||||||
MIC distribution | NS | - | NS | - | NS | NS | |||||
Reference guidelines | NS | - | NS | - |
ANF Class | ANF Drug | C. albicans | C. glabrata/complex | C. parapsilosis/complex | C. tropicalis | C. krusei | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
A | B | A | B | A | B | A | B | A | B | ||
Azole | Fluconazole | 6 (DK;IS;IT;ES;SE; UK) | 6 (BE, IT, PT, ES, CH, UK) | 6 (DK;IS;IT;ES;SE; UK) | 6 (BE, IT, PT, ES, CH, UK) | 5 (DK;IS;IT;ES;SE;) | 6 (BE, IT, PT, ES, CH, UK) | 5 (DK;IS;IT;ES;SE) | 5 (BE, IT, PT, ES, CH) | IR | |
Itraconazole | 4 (DK;IS;IT;ES) | 2 (ES, UK) | 3 (DK;IT;ES) | 2 (ES, UK) | 3 (DK;IT; ES) | 3 (BE, ES, UK) | 3 (DK;IT;ES) | 2 (BE, ES) | 3 (DK; IT;ES) | 2 (BE, ES) | |
Posaconazole | 2 (DK; IT) | 3 (BE, PT, ES) | 2 (DK; IT) | 1 (ES) | 2 (DK; IT) | 3 (BE, PT, ES) | 2 (DK; IT) | 3 (BE, PT, ES) | 2 (DK; IT) | 1 (ES) | |
Voriconazole | 5 (DK;IT;ES;SE; UK) | 5 (BE, PT, ES, CH, UK) | 5 (DK;IT;ES;SE; UK) | 4 (BE, ES, CH, UK) | 5 (DK;IT;ES;SE; UK) | 5 (BE, PT, ES, CH, UK) | 4 (DK;IT;ES;SE) | 4 (BE, PT, ES, CH) | 4 (DK;IT;ES;SE) | 3 (BE, ES, CH) | |
Echinocandin | Caspofungin | 6 (DK;IS;IT;ES;SE; UK) | 3 (IT, ES, CH) | 6 (DK;IS;IT;ES;SE; UK) | 3 (IT, ES, CH) | 5 (DK;IS;IT;ES;SE) | 3 (IT, ES, CH) | 5 (DK;IS;IT;ES;SE) | 3 (IT, ES, CH) | 4 (DK; IT; ES; SE) | 3 (IT, ES, CH) |
Anidulafungin | 3 (DK; It; SE) | 4 (BE, IT; PT, ES) | 3 (DK; IT; SE) | 4 (BE, IT; PT, ES) | 3 (DK; IT SE) | 3 (BE, PT, ES) | 3 (DK; IT; SE) | 4 (BE, IT; PT, ES) | 3 (DK; IT; SE) | 3 (IT, PT, ES) | |
Micafungin | 2 (DK; IT) | 4 (BE, IT; PT, ES) | 2 (DK; IT) | 4 (BE, IT; PT, ES) | 1 IT; | 4 (BE, IT; PT, ES) | 1 IT; | 2(IT, ES) | 1 IT; | 2 (IT, ES) | |
Polyene | Amphotericin B | 6 (DK;IS;IT; ES;SE; UK) | 3 (BE, PT, ES) | 6 (DK;IS;IT;ES;SE; UK) | 3 (BE, PT, ES) | 5 (DK;IS;IT;ES;SE) | 3 (BE, PT, ES) | 5 (DK;IS;IT;ES;SE) | 3 (BE, PT, ES) | 4 (DK;IT;ES;SE) | 3 (BE, PT, ES) |
Variable | Denmark (3 Studies) | Iceland (1 Study) | Italy (3 Studies) | Spain (1 Study) | Sweden (2 Studies) | UK (1 Study) |
---|---|---|---|---|---|---|
Study design | Prospective | NS | Prospective | Prospective | Prospective | Retrospective |
Retrospective | Retrospective | Retrospective | ||||
Years available | 2004–2009 2010–2011 2012–2015 | 2000–2011 | 2004–2005 2011–2013 2014–2015 | 2005–2006 | 2005–2006 2015–2016 | 2007–2011 |
Data presentation | Pooled | Pooled | Pooled | Pooled | Pooled | Pooled |
Data stratification (age, sex, sub-setting) | - | - | ||||
Incidence ▲ | - | - | ||||
IFI incidence denominator | Per 100,000 inhabitants | Per 100,000 inhabitants | Per 1000 admission OR Per 100 patients | - | Per 100,000 inhabitants | - |
Antifungal consumption | - | - | - | |||
Episodes definition | 🞼 | 🞼 | - | |||
🞼 | ||||||
Number of patients | ||||||
Total Candida isolates | ||||||
Species identification CA/NAC | ||||||
Molecular typing resistance | - | - | - | - | - | |
Laboratory method | ||||||
S/SDD/R or Non susceptible | NS | |||||
MIC distribution | NS | NS | NS | |||
Reference guidelines |
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Galia, L.; Pezzani, M.D.; Compri, M.; Callegari, A.; Rajendran, N.B.; Carrara, E.; Tacconelli, E.; the COMBACTE MAGNET EPI-Net Network. Surveillance of Antifungal Resistance in Candidemia Fails to Inform Antifungal Stewardship in European Countries. J. Fungi 2022, 8, 249. https://doi.org/10.3390/jof8030249
Galia L, Pezzani MD, Compri M, Callegari A, Rajendran NB, Carrara E, Tacconelli E, the COMBACTE MAGNET EPI-Net Network. Surveillance of Antifungal Resistance in Candidemia Fails to Inform Antifungal Stewardship in European Countries. Journal of Fungi. 2022; 8(3):249. https://doi.org/10.3390/jof8030249
Chicago/Turabian StyleGalia, Liliana, Maria Diletta Pezzani, Monica Compri, Astrid Callegari, Nithya Babu Rajendran, Elena Carrara, Evelina Tacconelli, and the COMBACTE MAGNET EPI-Net Network. 2022. "Surveillance of Antifungal Resistance in Candidemia Fails to Inform Antifungal Stewardship in European Countries" Journal of Fungi 8, no. 3: 249. https://doi.org/10.3390/jof8030249