Current Issue: Volume 16 Number 51	Published on: 21 December 2006	Current Issue in PDF PDF format (283 Kb)

Healthcare associated Infections

Last updated: 19 October 2006, Volume 16, No. 42 (PDF file, KB) Next update: 2007

HCAI Archives: | 2006 | 2005 |

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Voluntary surveillance of candidaemia in England, Wales, and Northern Ireland: 2005

There were 1736 reports of Candida spp isolated from blood specimens in England, Wales and Northern Ireland in 2005 (see E-Table 1). This represents a 16.3% increase in the number of candidaemia reports made to the HPA since 2004 (1493 reports) and is consistent with the increasing trend observed since 1990 [1]. However, the increase observed between 2004 and 2005 (16.3%) is over twice that reported between 2003 and 2004 (7.6%). The overall reported rate of candidaemia increased from 2.7 per 100,000 (95% CI: 2.6-2.9) in 2004 to 3.1 per 100,000 (95% CI: 3.0-3.3) in 2005 (see E-Table 1). As reporting is voluntary, these increases may be due in part to improved ascertainment.

• The highest country-specific rate of reported candidaemia was observed in Northern Ireland: 5.0/100,000 (95% CI: 4.0-6.2).
  
• Within the English regions, the South East had the lowest reported candidaemia rate with 1.6/100,000 (95% CI: 1.3-1.9) whereas the North West had the highest rate of reports with 4.1/100,000 (95% CI: 3.6-4.6) (see Figure 1).
  
• The largest regional change in the rate of reported candidaemia since 2004 was observed in the London region, which increased from 2.2/100,000 (95% CI: 1.8-2.5) in 2004 to 3.4/100,000 (95% CI: 3.0-3.8) in 2005.
  
• Candida albicans was the most frequently reported species in 2005, accounting for 55% of candidaemia reports, with the other common species including C. glabrata (18%) and
  C. parapsilosis (10%).Seven other uncommon species were responsible for the remaining seven per cent of invasive Candida infections (see E-Table 2).
  
• The proportion of reports in which invasive Candida infection was recorded without full species information decreased slightly from 10.4% in 2004 to 9.9% in 2005.
  
• Candidaemia rates were higher in males than females in most age groups (see Figure 2).
  
• The highest age and sex-specific rate of reported candidaemia in 2005 was in males aged under 1 year at 15.4/100,000 (95% CI: 11.5-20.1) followed by males aged 75 years and over at 12.1/100,000 (95% CI: 10.4-13.9).
  

Reporting to species level is important for monitoring changes in the epidemiology of these infections, with different species being associated with infections in different patient groups and with differing levels of antifungal susceptibility [2]. For assistance with identification, laboratories can submit isolates to the Mycology Reference Laboratory in Bristol, <http://ww.hpa.org.uk/srmd/mycology/index.htm>.

The analyses presented are based on data extracted from LabBase2* on the 22 September 2006 for the period from 2002 to 2005.Further data tables can be viewed in the full text online version: <http://www.hpa.org.uk/infections/topics_az/fungal_infections/epi_data.htm>.

Figure 1 Region-specific rates of candidaemia reports, England, Wales, and Northern Ireland: 2005

Figure 2 Age-specific rates of candidaemia per 100,000 population; England, Wales, and Northern Ireland: 2005

Further data tables and commentary about Candidaemia in England, Wales, and Northern Ireland: 2005 can be viewed at:
http://www.hpa.org.uk/infections/topics_az/fungal_infections/epi_data.htm

References
1. Lamagni TL, Evans BG, Shigematsu M, Johnson EM. Emerging trends in the epidemiology of invasive mycoses in England and Wales (1990-1999). Epidemiol Infect 2001; 126 : 397-414.

2. Hobson RP. The global epidemiology of invasive Candida infections - is the tide turning? J Hosp Infect 2003; 55 : 159-68.

Footnote
*Labbase2 is the database that collects laboratory reports of all microorganisms isolated at nearly 400 NHS and other laboratories throughout England and Wales. The database is managed and accessed at the Centre for Infections.