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Cited by 478Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesFungal Infections and Studies

Epidemiology of Candidemia in Swiss Tertiary Care Hospitals: Secular Trends, 1991–2000

Open access
Marchetti, Oscar, Bille, Jacques, Fluckiger, Ursula, Eggimann, Philippe, Ruef, Christian, Garbino, Jorge, Calandra, Thierry, Glauser, Michel‐Pierre +3 more·2004·Clinical Infectious Diseases
DOI 10.1086/380637
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Abstract

Candida species are among the most common bloodstream pathogens in the United States, where the emergence of azole-resistant Candida glabrata and Candida krusei are major concerns. Recent comprehensive longitudinal data from Europe are lacking. We conducted a nationwide survey of candidemia during 1991-2000 in 17 university and university-affiliated hospitals representing 79% of all tertiary care hospital beds in Switzerland. The number of transplantations and bloodstream infections increased significantly (P<.001). A total of 1137 episodes of candidemia were observed: Candida species ranked seventh among etiologic agents (2.9% of all bloodstream isolates). The incidence of candidemia was stable over a 10-year period. C. albicans remained the predominant Candida species recovered (66%), followed by C. glabrata (15%). Candida tropicalis emerged (9%), the incidence of Candida parapsilosis decreased (1%), and recovery of C. krusei remained rare (2%). Fluconazole consumption increased significantly (P<.001). Despite increasing high-risk activities, the incidence of candidemia remained unchanged, and no shift to resistant species occurred.

Integrity signals

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Crossref · 10.1086/380637

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 34 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § RESULTS · p. 4

    A total of 1137 episodes of candidemia were observed in the survey.

    “These 6 centers reported 774 (68%) of all 1137 episodes of candidemia recorded in the survey over 10 years.”
    Quote in the paperSubstantial claim
  • Findingown data
    § RESULTS · p. 3

    Solid-organ transplantations increased 95% from 108 to 211 during 1991-2000 in 3 university hospitals.

    “solid-organ transplantations increased 95% during the same period, from 108 to 211 ( ; )”
    Quote in the paperNot a substantial claim
  • Findingown data
    § RESULTS · p. 3

    Hematopoietic stem cell transplantations increased 124% from 55 in 1992 to 123 in 2000 in 3 university hospitals.

    “hematopoietic stem cell transplantations increased 124%, from 55 in 1992 to 123 in 2000 ( ; r p 0.83 P ! .005)”
    Quote in the paperNot a substantial claim
  • Findingown data
    § RESULTS · p. 5

    The overall distribution of Candida species was stable during 1991-2000.

    “Overall, the species distribution was stable (figure 3).”
    Quote in the paperNot a substantial claim
  • Findingown data
    § RESULTS · p. 5

    During 1991-2000, the incidence of candidemia showed no significant trend in university hospitals and university-affiliated hospitals.

    “No significant trend was observed during the 10-year period among university hospitals and universityaffiliated hospitals (figure 1 C ).”
    • Also stated in: § DISCUSSION · p. 7 · plain
      “In Switzerland, the incidence of candidemia remained essentially unchanged during the 10-year study period.”
    Quote in the paperSubstantial claim
  • May combine two claims. 30
  • The quote only partly states this claim. 5
  • Classified as probably not a substantial claim. 24

  • May combine two claims.

    Findingown data
    § RESULTS · p. 4

    In the 6 centers with longitudinal data, 533,490 blood cultures were performed over 10 years, of which 52,565 (9.8%) were positive.

    “In these institutions, 533,490 blood cultures were performed over a 10-year period. Of these, 52,565 (9.8%) were positive (i.e., cultures yielded any pathogen).”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data
    § RESULTS · p. 5

    The overall proportion of non-albicans Candida species was 36% in university hospitals and 31% in university-affiliated hospitals, a non-significant difference.

    “the overall proportion of nonalbicans species of Candida was 36% in university hospitals and 31% in universityaffiliated hospitals ( ).”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data
    § RESULTS · p. 4

    No significant difference was observed between university and university-affiliated institutions in the distribution of Candida isolates by hospital sector.

    “No significant difference was observed between university and university-affiliated institutions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Epidemiology of Candidemia in Swiss T ertiary Care Hospitals: Secular T rends, 1991-2000 · p. 1

    The incidence of C. parapsilosis decreased, accounting for 1%.

    “the incidence of Candida parapsilosis decreased (1%)”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The species identification methods remained consistent across hospitals and over the 10-year period.

  • May combine two claims.

    Findingown data
    § RESULTS · p. 5

    Fluconazole administration increased progressively for both parenteral and oral forms during 1991-2000.

    “A progressive increase in the quantities of the parenteral and oral forms that were administered was observed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § RESULTS · p. 3

    Most cases of acute leukemia (71%) and transplantations (92%) were reported by university hospitals in 2000.

    “In 2000, most cases of acute leukemia (71%) and transplantations (92%) were reported by university hospitals.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Epidemiology of Candidemia in Swiss T ertiary Care Hospitals: Secular T rends, 1991-2000 · p. 1

    C. glabrata was the second most common species, accounting for 15%.

    “followed by C. glabrata (15%)”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The species identification methods remained consistent across hospitals and over the 10-year period.

  • May combine two claims. The quote only partly states this claim.

    Findingown data
    § DISCUSSION · p. 7

    C. parapsilosis decreased from 6% during 1991-1993 to 1% during 2000, a significant change.

    “that of Candida parapsilosis decreased from 6% to 1% ( )”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data
    § RESULTS · p. 3

    The overall incidence of candidemia in 2000 was 0.49 cases per 10,000 patient-days.

    “The overall incidence of infection was 0.49 cases per 10,000 patient-days.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § RESULTS · p. 5

    C. glabrata was the second most common species recovered, at 14% during 1991-1993 and 15% during 2000.

    “C. glabrata was the second most common species recovered (14% during 1991-1993 and 15% during 2000).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Epidemiology of Candidemia in Swiss T ertiary Care Hospitals: Secular T rends, 1991-2000 · p. 1

    Candida species ranked seventh among etiologic agents of bloodstream infections, accounting for 2.9% of all bloodstream isolates.

    “Candida species ranked seventh among etiologic agents (2.9% of all bloodstream isolates).”
    • Also stated in: § RESULTS · p. 4 · plain
      “Candida species accounted for 2.9% of the bloodstream pathogens (median annual proportion, 2.8%; range, 2.3%-3.4%) and ranked seventh”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data
    § DISCUSSION · p. 7

    C. tropicalis increased from 2% during 1991-1993 to 9% during 2000, a significant change.

    “The proportion of Candida tropicalis increased from 2% to 9% ( )”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § DISCUSSION · p. 6

    The number of blood cultures and transplantations performed increased significantly during the study period.

    “The analysis of hospital characteristics and activities shows a significant increase in the number of blood cultures and transplantations performed”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § RESULTS · p. 5

    Resistant non-albicans isolates included 5 C. glabrata, 1 C. krusei, 1 C. norvegiensis, and 1 C. tropicalis.

    “Resistant nonalbicans isolates of Candida included 5 C. glabrata isolates, 1 C. krusei isolate, 1 Candida norvegiensis isolate, and 1 C. tropicalis isolate.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § RESULTS · p. 5

    In 1991, 2.1 g per 10,000 patient-days of fluconazole was given intravenously and 5.2 g orally; in 2000, the corresponding amounts were 12.2 g and 17.8 g.

    “In 1991, 2.1 and 5.2 g per 10,000 patient-days were administered intravenously and orally, respectively; in 2000, 12.2 and 17.8 g per 10,000 patient-days were administered, respectively”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § DISCUSSION · p. 6

    Candida organisms ranked sixth through ninth among recovered bloodstream pathogens and accounted for 2%-3% of all isolates during the study period.

    “Candida organisms ranged from the sixth through ninth most recovered bloodstream pathogens and accounted for 2%-3% of all isolates during this period.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given
    § DISCUSSION · p. 7

    One-third of all candidemia episodes occurred in ICUs, one-third in medical wards (including hemato-oncology units), and one-fourth in surgical wards.

    “In Switzerland, one-third of all episodes of candidemia occurred in ICUs, onethird in medical wards (including hemato-oncology units), and one-fourth in surgical wards.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § RESULTS · p. 5

    In 1999-2000, fluconazole susceptibility data were available for 96 (39%) of 245 Candida isolates: 90 (60%) of 151 isolates from university hospitals and 6 (6%) of 94 from university-affiliated hospitals.

    “In 1999-2000, data on fluconazole susceptibility were available for 96 (39%) of 245 Candida isolates, comprising 90 (60%) of 151 isolates from university hospitals and 6 (6%) of 94 from university-affiliated hospitals ( ).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § DISCUSSION · p. 7

    In 2000, incidence was 0.54 episodes per 10,000 patient-days (0.36 per 1000 admissions) in university hospitals and 0.40 episodes per 10,000 patient-days (0.15 per 1000 admissions) in university-affiliated hospitals.

    “In 2000, 0.54 episodes per 10,000 patient-days (0.36 episodes per 1000 hospital admissions) and 0.40 episodes per 10,000 patient-days (0.15 episodes per 1000 hospital admissions) were reported in university and university-affiliated hospitals, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data
    § Epidemiology of Candidemia in Swiss T ertiary Care Hospitals: Secular T rends, 1991-2000 · p. 1

    The survey included 17 university and university-affiliated hospitals representing 79% of all tertiary care hospital beds in Switzerland.

    “We conducted a nationwide survey of candidemia during 1991-2000 in 17 university and university-affiliated hospitals representing 79% of all tertiary care hospital beds in Switzerland.”
    • Also stated in: § RESULTS · p. 2 · plain
      “A total of 9333 beds representing 79% of all tertiary care hospital beds in Switzerland were included in the survey”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given
    § METHODS · p. 2

    The participating institutions serve the majority of the Swiss population (84%).

    “These institutions are distributed across the country and play a key role in the national health care system by serving the majority of the population of Switzerland ( ∼ 6,100,000 [84%] of 7,200,000 residents).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation
    § METHODS · p. 2

    All laboratories used automated blood culture systems and recognized standard laboratory techniques for Candida species identification.

    “All laboratories used automated blood culture systems (12 used Bactec [Becton Dickinson] and 5 used BacT/Alert [bioMe ´rieux]), and 7 (44%) of 16 used special blood culture bottles for fungus detection (5 used Bactec Mycosis IC/F vials [Becton Dickinson] and 2 used other types). Recognized standard laboratory techniques for Candida species identification were used by all laboratories [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Warren N, Hazen K. Candida, Cryptococcus, and other yeasts of medical importance. In: Murray PR, ed. Manual of clinical microbiology. Washington, DC: ASM Press, 1999:1184-1199.

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given
    § METHODS · p. 2

    All Swiss university hospitals and a representative sample of university-affiliated tertiary care teaching centers were included in the survey.

    “All Swiss university hospitals (5 health care centers and 2 independent pediatric hospitals) and a representative sample of university-affiliated tertiary care teaching centers ( ) were included in a retrospective surn p 11 vey.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given
    § METHODS · p. 2

    All hematopoietic stem cell and solid-organ transplantations are performed in these centers.

    “All hematopoietic stem cell and solid-organ transplantations are performed in these centers”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given
    § METHODS · p. 2

    Returned questionnaires were checked for completeness and consistency, and those with missing data or inconsistencies were returned for correction.

    “Returned questionnaires (from 17 of the 18 hospitals) were checked by the survey coordinators for completeness and consistency. Those with missing data or inconsistencies were returned for completion and/or correction.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation
    § METHODS · p. 2

    Antifungal susceptibility testing was performed in 7 (44%) of 16 laboratories, with quality control based on NCCLS recommendations.

    “Antifungal susceptibility testing, the quality control of which was based on NCCLS recommendations, was performed in 7 (44%) of 16 laboratories [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] NCCLS. Reference method for broth dilution antifungal susceptibility testing of yeasts; approved standard. NCCLS document M27-A. Villanova, PA: NCCLS, 1997.

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given
    § DISCUSSION · p. 8

    The study provides a longitudinal overview of secular trends associated with patient-care activities and is representative of the entire country over a 10-year period.

    “It provides a longitudinal overview of the secular trends associated with patient-care activities, which is representative of the entire country over a 10-year period.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 6

    A similar evolution was observed in Asia.

    “A similar evolution was observed in Asia [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Chen YC, 1997, Infect Control Hosp Epidemiol source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given
    § DISCUSSION · p. 8

    Despite the absence of a centralized laboratory, this retrospective study is the largest European series of candidemia and one of the largest worldwide.

    “Despite the lack of a centralized laboratory, this retrospective study represents the largest European series of candidemia and one of the largest worldwide.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data
    § DISCUSSION · p. 8

    Candidemia incidence remained stable despite increasing high-risk activities, and no shift to azole-resistant Candida species was observed.

    “The incidence of candidemia remained stable, despite increasing high-risk activities, and no shift to azole-resistant Candida species was observed.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given
    § DISCUSSION · p. 8

    Improved infection-control practices may have contributed to stabilizing candidemia incidence despite an increase in high-risk patient-care activities.

    “On the other hand, improved infection-control practices might have contributed to such stabilization, despite an increase of high-risk patient-care activities.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 6

    Invasive candidiasis became a major problem in US hospitals during the 1980s.

    “Invasive candidiasis emerged as a major problem in US hospitals in the 1980s [5, 7].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [5] source

      Not checked in the free run.

    • cites [7] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 6

    An inverse trend occurred during 1989-1999 among ICUs in US hospitals reporting to the NNIS system.

    “However, an inverse trend was observed during 19891999 among ICUs in US hospitals reporting to the NNIS system [8].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given
    § DISCUSSION · p. 7

    The emergence of Candida species with decreased susceptibility or intrinsic resistance to azoles was a major concern in the 1990s.

    “The emergence of Candida species with decreased susceptibility or intrinsic resistance to azoles was a major concern in the 1990s.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 7

    Other North American and European investigators confirmed these observations in larger hospital settings.

    “Other North American and European investigators confirmed these observations in larger hospital settings [10, 11, 13, 20, 22, 25, 26].”
    Quote in the paperNot a substantial claim0 of 7 sources checked
    • cites [10] Abi-Said D, 1997, Clin Infect Dis source

      Not checked in the free run.

    • cites [11] Viscoli C, 1999, Clin Infect Dis source

      Not checked in the free run.

    • cites [13] source

      Not checked in the free run.

    • cites [20] Berrouane YF, 1999, J Clin Microbiol source

      Not checked in the free run.

    • cites [22] source

      Not checked in the free run.

    • cites [25] source

      Not checked in the free run.

    • cites [26] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 7

    This phenomenon was first reported in the United States in neutropenic recipients of bone marrow transplants.

    “This phenomenon was first reported in the United States in neutropenic recipients of bone marrow transplants [9].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Wingard JR, 1991, N Engl J Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given
    § DISCUSSION · p. 6

    Other recent multicenter longitudinal data from Europe are lacking.

    “Other recent multicenter longitudinal data from Europe are lacking.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 7

    Ten years later, Berrouane et al. observed 0.98 episodes of candidemia per 10,000 patient-days in one US tertiary care center.

    “Ten years later, Berrouane et al. [20] observed 0.98 episodes of candidemia per 10,000 patient-days in 1 US tertiary care center.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Berrouane YF, 1999, J Clin Microbiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 6

    No significant change was reported in one Swiss hospital between 1989 and 2000.

    “No significant change was reported in 1 Swiss hospital between 1989 and 2000 [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § DISCUSSION · p. 6

    In Europe, contrasting data were reported in the early 1990s: candidemia incidence increased in The Netherlands and remained stable in Norway.

    “In Europe, contrasting data were reported in the early 1990s-the incidence of candidemia increased in The Netherlands and remained stable in Norway [13, 15].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [13] source

      Not checked in the free run.

    • cites [15] Sandven P, 1998, J Clin Microbiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 7

    The distribution of Candida species plays a key role in establishing efficient management strategies.

    “The distribution of Candida species plays a key role for establishing efficient management strategies [23, 24].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [23] source

      Not checked in the free run.

    • cites [24] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § DISCUSSION · p. 8

    A study from one Swiss university hospital reported no shift to non-albicans Candida species despite a significant increase in fluconazole use between 1989 and 2000.

    “In contrast, a study from 1 Swiss university hospital reported no shift to nonalbicans species of Candida, despite a significant increase in fluconazole use between 1989 and 2000 [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 8

    The role of widespread azole use in the shift to resistant Candida species has been largely debated and remains controversial.

    “The role of the widespread use of azoles in the shift to resistant Candida species has been largely debated and remains controversial [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] White MH, 1997, Clin Infect Dis source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § DISCUSSION · p. 7

    The species distributions were very close to those reported in Norway during the early 1990s, in Italy during an ECCM survey in the late 1990s, and in Wales.

    “The species distributions were very close to those reported in Norway during the early 1990s, in Italy during an ECCM survey conducted in the late 1990s, and in Wales [15, 22, 28].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [15] Sandven P, 1998, J Clin Microbiol source

      Not checked in the free run.

    • cites [22] source

      Not checked in the free run.

    • cites [28] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § DISCUSSION · p. 8

    Two groups observed an important increase of C. glabrata fungemia in the 1990s and analyzed fluconazole consumption over time.

    “Two groups observed an important increase of C. glabrata fungemia in the 1990s and analyzed fluconazole consumption over time.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 7

    Trick et al. recently confirmed these trends in patients in US ICUs.

    “Trick et al. [8] recently confirmed these trends in patients in US ICUs.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 8

    Voss et al. evaluated annual nationwide fluconazole use in The Netherlands in kilograms and observed a fourfold increase between 1990 and 1995.

    “Voss et al. [13] evaluated the annual nationwide fluconazole use in The Netherlands in kilograms and observed a 4-fold increase between 1990 and 1995.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION · p. 8

    Berrouane et al. observed a substantial increase in fluconazole use, from 3 to 33 g per 10,000 patient-days in 1990 and 1994, respectively.

    “Similarly, Berrouane et al. [20] observed a substantial increase in fluconazole use, from 3 to 33 g per 10,000 patient-days in 1990 and 1994, respectively.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Berrouane YF, 1999, J Clin Microbiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisenone given
    § DISCUSSION · p. 7

    In institutions where this shift occurred, proportions of C. glabrata and C. krusei were 15%-45% and 5%-20%, respectively.

    “In institutions where this shift occurred, proportions of C. glabrata and C. krusei were 15%-45% and 5%20%, respectively.”
    Quote in the paperNot a substantial claim
49 of 49

  • The paper relies on this without support.

    No recent longitudinal multicenter study on candidemia in Europe had been performed before this survey.

    “to our knowledge, no recent longitudinal multicenter study has been performed in Europe.”

  • The paper relies on this without support.

    The participating hospitals' candidemia surveillance data are complete and accurate for the study period.

    “Data on the number of patient-days spent in the hospital, the transplantation activities, the number of blood cultures performed, the 10 most frequently recovered bloodstream isolates, and the consumption of fluconazole during 1991-2000 were additionally obtained from a representative sample of university and university-affiliated hospitals.”

  • The paper relies on this without support.

    Blood culture practices and the number of blood cultures performed are valid indicators of the incidence of bloodstream infections.

    “The number of transplantations and bloodstream infections increased significantly ( ).”

  • The paper relies on this without support.

    Fluconazole consumption data from the representative sample reflect national fluconazole consumption in Swiss tertiary care hospitals.

    “Fluconazole consumption increased significantly ( ).”

  • The paper relies on this without support.

    The species identification methods remained consistent across hospitals and over the 10-year period.

    “Recognized standard laboratory techniques for Candida species identification were used by all laboratories [16].”

  • The paper relies on this without support.

    Critically ill and severely immunocompromised patients are at particularly high risk for invasive candidiasis.

    “Critically ill and severely immunocompromised patients are at particularly high risk for invasive candidiasis.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conclusion denies a reported resistant C. albicans isolate

    Major

    The discussion says no resistance was observed in C. albicans, but the susceptibility results report one resistant isolate. This directly contradicts a conclusion about resistance.

  • Percentage with ward-location data is incorrect

    Minor

    The reported 92 patients out of 117 constitute 78.6%, which rounds to 79%, not 77%.

    Reported 77 · recomputed 78.632479

  • ICU percentage for 1991-1995 is overstated

    Minor

    The stated 109 ICU episodes out of 355 are 30.7%, which rounds to 31%, not 32%.

    Reported 32 · recomputed 30.704225

3 of 3

Cites

Flagged first, then by citations

2 of the 34 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Beck-Sague CM, 1993, The National Nosocomial Infection Surveillance System. J Infect Dis, 167, 1247

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Authors
Marchetti, O., Bille, J., Fluckiger, U., Eggimann, P., Ruef, C., Garbino, J., Calandra, T., Glauser, M., Tauber, M. G., Pittet, D., & Fungal Infection Network of Switzerland (FUNGINOS)
Affiliations
  • Centre Hospitalier Universitaire Vaudois (CH)
  • University Hospital of Geneva (CH)
  • University of Zurich (CH)
Corresponding author
Marchetti, Oscar
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2004-02
Volume
38
Issue
3
Pages
311-320
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/380637
OpenAlex
W2156803121
Semantic Scholar
0d5bcae50ab2bf491c4b0a502cd9e553f5257a3a
Cited by
478
References
34
Citations by year
2026: 1 · 2025: 12 · 2024: 11 · 2023: 7 · 2022: 14 · 2021: 13 · 2020: 18 · 2019: 12 · 2018: 21 · 2017: 21 · 2016: 24 · 2015: 22 · 2014: 31 · 2013: 29 · 2012: 18
FWCI
20.53
Type
journal article
Language
en
Open access
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • SERVAL (Université de Lausanne) (publishedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
  • reroDoc Digital Library (submittedVersion)
  • IRIS (submittedVersion)
  • BORIS (University Library Bern) (submittedVersion, other-oa)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich)
  • Open Access CRIS of the University of Bern
Funders
Pfizer
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
candidemia, Candida species, bloodstream infection, Candida albicans, Candida glabrata, Candida tropicalis, Candida parapsilosis, Candida krusei, azole resistance, transplant recipients, incidence trends, Switzerland
MeSH terms
Antifungal Agents, Candidiasis, Cross Infection, Data Collection, Drug Resistance, Microbial, Hospitals, University, Humans, Longitudinal Studies, Microbial Sensitivity Tests, Switzerland, United States, Fluconazole, Fungemia

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-05.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-05.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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