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Journal of Clinical Microbiology, December 1998, p. 3455-3459, Vol. 36, No. 12
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Constant Low Rate of Fungemia in Norway, 1991 to 1996

Per Sandven,1,* Lars Bevanger,2 Asbjørn Digranes,3 Peter Gaustad,4 Hanne H. Haukland,5 Martin Steinbakk,6 and The Norwegian Yeast Study Groupdagger

Department of Bacteriology, National Institute of Public Health, 0462 Oslo,1 Department of Microbiology, Regional Hospital, Norwegian University of Science and Technology, 7006 Trondheim,2 Department of Microbiology and Immunology, Haukeland Hospital, 5021 Bergen,3 Microbiological Institute, National Hospital, University of Oslo, 0027 Oslo,4 Department of Microbiology, University Hospital, 9038 Tromsø,5 and Department of Microbiology, Ullevål University Hospital, 0407 Oslo,6 Norway

Received 10 April 1998/Returned for modification 20 July 1998/Accepted 30 August 1998

Since 1991 information on yeast isolates from blood cultures has been recorded prospectively from all microbiological laboratories (5 university and 16 county or local hospital laboratories) in Norway (population, 4.3 million). From 1991 to 1996 a total of 571 episodes of fungemia in 552 patients occurred (1991, 109 episodes; 1992, 81 episodes; 1993, 93 episodes; 1994, 89 episodes; 1995, 98 episodes; and 1996, 101 episodes). The fungemia rates per 10,000 patient days were 0.29 in 1991 and 0.27 in 1996. The average rates for the years 1991 to 1996 were 0.37 for the university laboratories and 0.20 for the other laboratories. These rates are low compared to the rate (0.76) in five Dutch university hospitals in 1995 and the rate (2.0) in Iowa in 1991. The four most frequently isolated species were Candida albicans (66%), Candida glabrata (12.5%), Candida parapsilosis (7.6%), and Candida tropicalis (6.4%). The incidences of both C. albicans (range, 63 to 73%) and C. glabrata (range, 8.4 to 15.7%) varied somewhat throughout this period, but no significant increase or decrease was noted. MICs of amphotericin B, flucytosine, and fluconazole were determined for 89% of the isolates. All were susceptible to amphotericin B, and only 29 (5.6%) strains had decreased susceptibility to flucytosine. All C. albicans isolates were susceptible to fluconazole. The percentage of yeast isolates with decreased susceptibility to fluconazole (MICs, >= 16 µg/ml) did increase, from 9.6% in 1991 and 1992 to 12.2% in 1994, 16.1% in 1995, and 18.6% in 1996. This was largely due to increases in the percentages of resistant C. glabrata and Candida krusei strains in the last 2 years. Compared to the incidence in other countries, it is remarkable that Norway has such a low and constant incidence of fungemia. A possible reason for this difference might be a restricted antibiotic use policy in Norway.

* Corresponding author. Mailing address: Department of Bacteriology, National Institute of Public Health, P.O. Box 4404 Torshov, N-0403 Oslo, Norway. Phone: 47 22 04 22 00. Fax: 47 22 04 25 18. E-mail: per.sandven{at}labmed.uio.no.

dagger The Norwegian Yeast Study Group consists of one representative from each clinical microbiological laboratory in Norway. The group includes E. H. Aandahl, Department of Microbiology, LIMIK, Lillehammer; T. Bergan, Department of Microbiology, Aker Hospital, Oslo; N. O. Hermansen, Department of Microbiology, Buskerud Central Hospital, Drammen; E. Holten, Department of Microbiology, Akershus Central Hospital, Nordbyhagen; J. Lassen, Department of Microbiology, Norwegian Radium Hospital, Oslo; T. Mannsåker, Department of Microbiology, Sogn and Fjordane Central Hospital, Førde; L. Mortensen, Nordland Central Hospital, Bodø; F. Müller, Bærum Hospital, Bærum; O. B. Natås, Rogaland Central Hospital, Stavanger; Å. K. Nordius, Department of Microbiology, Innherred Central Hospital, Levanger; E. Ragnhildstveit, Department of Microbiology, Østfold Central Hospital, Fredrikstad; T. Skarpaas, Department of Microbiology, Vest-Agder Central Hospital, Kristiansand; T. Thoresen, Vestfold Central Hospital, Tønsberg; Y. Tveten, A/S Telelab, Skien; and E. Vik, Department of Microbiology, Molde County Hospital, Molde.

Journal of Clinical Microbiology, December 1998, p. 3455-3459, Vol. 36, No. 12
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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