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Journal of Clinical Microbiology, June 2006, p. 1977-1981, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.00029-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Candidemia in Norway (1991 to 2003): Results from a Nationwide Study

Per Sandven,1,2* Lars Bevanger,3 Asbjørn Digranes,4 Hanne H. Haukland,5 Turid Mannsåker,6 Peter Gaustad,1,7 and the Norwegian Yeast Study Group

Institute of Medical Microbiology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo,1 Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo,2 Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, and Department of Microbiology, St. Olavs Hospital, University Hospital of Trondheim, Trondheim,3 Department of Microbiology and Immunology, Haukeland University Hospital, Bergen,4 Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø,5 Department of Microbiology, Ullevål University Hospital, Oslo,6 University of Oslo, Oslo, Norway7

Received 6 January 2006/ Returned for modification 17 February 2006/ Accepted 21 March 2006

A long-term, nationwide prospective candidemia study has been ongoing in Norway since 1991. All medical microbiological laboratories in the country have participated. During the period 1991 to 2003 a total of 1,393 episodes of candidemia occurred in 1,348 patients. The incidence of candidemia episodes per 100,000 inhabitants increased from approximately 2 episodes in the early 1990s to 3 episodes in 2001 to 2003. The average annual incidences varied markedly between the age groups. The incidence was high in patients aged <1 year and in patients aged ≥70 years. In patients ≥80 years of age, the incidence has increased during the last 3 years from an annual average of 6.5 to 15.6 cases/100,000 inhabitants in 2003. Four Candida species (C. albicans [70%], C. glabrata [13%], C. tropicalis [7%], and C. parapsilosis [6%]) accounted for 95.5% of the isolates. The species distribution has been constant during the 13-year study period. The distribution of the most important species varied with the age of the patient. In patients <1 year of age, the majority of episodes were caused by C. albicans (91%). The occurrence of C. glabrata increased with age. In patients ≥80 years of age, approximately 1/3 of all episodes were due to this species. All C. albicans strains were susceptible to fluconazole. The percentage of yeast isolates with decreased susceptibility to fluconazole (MICs ≥ 16 µg/ml) was 10.7% during the first period of this study (1991 to 1996) and 11.7% during the second period (1997 to 2003).

* Corresponding author. Mailing address: Division of Infectious Disease Control, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, N-0403 Oslo, Norway. Phone: 47 22 04 27 64. Fax: 47 22 04 25 18. E-mail: per.sandven{at}fhi.no.

Journal of Clinical Microbiology, June 2006, p. 1977-1981, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.00029-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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