Infectious diseases: Edited by Thierry Calandra, Oscar Marchetti, Philippe EggimannEpidemiology of invasive candidiasisArendrup, Maiken CAuthor Information Department of Microbiological Surveillance and Research, Division of Microbiology and Diagnostics, Statens Serum Institute, Copenhagen, Denmark Correspondence to Dr Maiken C. Arendrup, MD, PhD, Head of Unit, Unit of Mycology, Department of Microbiological Surveillance and Research, Division of Microbiology and Diagnostics, Statens Serum Institute building 43/117, Artillerivej 5, Copenhagen DK-2300, Denmark Tel: +45 32 68 32 23; e-mail: [email protected] Current Opinion in Critical Care: October 2010 - Volume 16 - Issue 5 - p 445-452 doi: 10.1097/MCC.0b013e32833e84d2 Buy Metrics Abstract Purpose of review This review covers candidaemia in numbers, susceptibility issues, host groups, risk factors and outcome. Recent findings The incidence of candidaemia has increased over the last decades. Candida glabrata is particularly common in the northern hemisphere and with increasing age whilst the opposite is true for C. parapsilosis, C. glabrata, C. krusei and a number of emerging species are not fully susceptible to azoles. C. parapsilosis and C. guilliermondii are not fully susceptible to echinocandins. Increasing rates of C. parapsilosis have been observed at centres with a high use of echinocandins, and outcome for this species is not superior comparing echinocandins with fluconazole. Acquired azole resistance has recently been described in as many as a third of 19% resistant isolates and echinocandin resistance has emerged and been detected as early as day 12 of echinocandin therapy. ICU stay and abdominal surgery are among the most important risk factors. Outcome is dependent on species involved, timing, dosing and choice of therapy and management of the primary focus of infection. However, host factors are dominating predictors of mortality in recent studies of ICU candidiasis. Summary The changing epidemiology highlights the need for close monitoring of local incidence, species distribution and susceptibility in order to optimize therapy and outcome. © 2010 Lippincott Williams & Wilkins, Inc.