Changes in the epidemiological landscape of invasive candidiasis

Lamoth, Frederic; Lockhart, Shawn R; Berkow, Elizabeth L; Calandra, Thierry

doi:10.1093/jac/dkx444

Cited by 547Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesFungal Infections and Studies

Changes in the epidemiological landscape of invasive candidiasis

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Lamoth, Frederic, Lockhart, Shawn R, Berkow, Elizabeth L, Calandra, Thierry·2018·Journal of Antimicrobial Chemotherapy

DOI 10.1093/jac/dkx444PMC PMC11931512

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Abstract

The epidemiology of invasive candidiasis has evolved in recent years, warranting a review of the changes and the implications for current and future diagnosis and treatment. The overall burden of invasive candidiasis remains high, particularly in the expanding populations of patients at risk of opportunistic infection, such as the elderly or immunosuppressed. Progressive shifts from Candida albicans to non-albicans Candida spp. have been observed globally. The recent emergence of novel, multiresistant species, such as Candida auris, amplifies the call for vigilance in detection and advances in treatment. Among the current treatment options, fluconazole is still widely used throughout the world. Increased resistance to fluconazole, both acquired and naturally emerging, has been observed. Resistance to echinocandins is presently low but this may change with increased use. Improvement of diagnostic techniques and strategies, development of international surveillance networks and implementation of antifungal stewardship programmes represent major challenges for a better epidemiological control of invasive candidiasis.

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The majority of these infections in the United States have historically been caused by C. albicans, although in recent years this species is now responsible for < 50% of all Candida bloodstream infections.
“The majority of these infections in the United States have historically been caused by C. albicans, although in recent years this species is now responsible for < 50% of all Candida bloodstream infections [4, 5].”
From Invasive candidiasis species distribution and trends, United States, 2009-2017 (2021) · cites this paper as [5]
The ‘Distribution trends towards non-albicans Candida species’ section (page unavailable) says that the US proportion of C. albicans has fallen significantly and is now below 50%. It does not explicitly establish that C. albicans historically caused a majority of US Candida bloodstream infections. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Several European countries have also seen increases in the incidence of IC.
“and several European countries have also seen increases in the incidence of IC [5, 14].”
From Invasive candidiasis species distribution and trends, United States, 2009-2017 (2021) · cites this paper as [5]
Currently, there are no population-based data sources for invasive candidiasis in Asia, the Middle East, Africa, or Latin America.
“Currently, there are no population-based data sources for Asia, the Middle East, Africa, or Latin America.44”
From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [44]
Lack of standardized methodologies and denominators limit the ability to compare estimates of invasive candidiasis burden.
“Lack of standardized methodologies and denominators limit the ability to compare estimates of IC burden.44”
From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [44]
The most common sites of infection in pregnant and postpartum women are the urinary system (5.2%), reproductive system (such as chorioamnionitis, 27.6%) and respiratory system (13.8%). Other common infections include surgical incision infections and skin and soft tissue infections (3.5%).
“The most common sites of infection in pregnant and postpartum women are the urinary system (accounting for 5.2%), reproductive system (such as chorioamnionitis, accounting for 27.6%) and respiratory system (accounting for 13.8%).35,36 Other common infections include surgical incision infections and skin and soft tissue infections (accounting for 3.5%).37,38”
From Clinical and Pathogenic Characteristics of 45 Cases of Bloodstream Infection in Obstetrics: A Clinical Analysis (2026) · cites this paper as [35]
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[46]46. Magobo RE, Corcoran C, Seetharam S et al. Candida auris-associated can- didemia, South Africa. Emerg Infect Dis 2014; 20: 1250-1.

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Authors: Lamoth, F., Lockhart, S. R., Berkow, E. L., & Calandra, T.
Affiliations: Centers for Disease Control and Prevention (US)
University of Lausanne (CH)
Corresponding author: Lockhart, Shawn R
ORCID: Lockhart, Shawn R
Berkow, Elizabeth L
Calandra, Thierry
Venue: Journal of Antimicrobial Chemotherapy
Publisher: Oxford University Press (OUP)
Published: 2018-01-01
Volume: 73
Issue: suppl_1
Pages: i4-i13
ISSN: 0305-7453 (ISSN-L)
1460-2091
DOI: 10.1093/jac/dkx444
PMC: PMC11931512
OpenAlex: W2782394839
Cited by: 547
References: 148
Citations by year: 2026: 43 · 2025: 68 · 2024: 66 · 2023: 66 · 2022: 69 · 2021: 82 · 2020: 80 · 2019: 53 · 2018: 17 · 2017: 2
FWCI: 6.39
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: public-domain
Locations: Journal of Antimicrobial Chemotherapy (publishedVersion, public-domain)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
IRIS (submittedVersion)
SERVAL (Université de Lausanne) (submittedVersion)
Funders: Cidara Therapeutics
National Institutes of Health (CC999999)
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: invasive candidiasis, Candida albicans, non-albicans Candida, Candida auris, fluconazole resistance, echinocandin resistance, antifungal stewardship, surveillance networks, immunocompromised patients, opportunistic fungal infection
MeSH terms: Antimicrobial Stewardship, Antifungal Agents, Candida, Humans, Global Health, Prevalence, Drug Resistance, Fungal, Candidiasis, Invasive, Epidemiological Monitoring

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