EPI-Net paper on bloodstream infections by fungi of the Candida genus

Ecraid's epidemiology network EPI-NET, which includes researchers from the University of Verona and Tübingen University Hospital, expanded our knowledge on bloodstream infections caused by fungi of the Candida genus. Their comprehensive review of the latest data on candidemia and antifungal resistance rates for six pathogens was published in the Journal of Fingi.

Since 2017, the EPI-Net research team has been working to provide a continuously updated repository of surveillance data regarding bacterial antimicrobial resistance (AMR), healthcare-related infections (HAIs), fungal bloodstream infections (candidemiae), outbreaks from resistant pathogens, and emerging resistances to newly approved antibiotics in Europe.

This new study includes a comprehensive review of the latest data on candidemia and antifungal resistance rates for six pathogens: C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, and C. auris. Following the EPI-Net protocol, journal publications and surveillance systems have been inspected across 32 countries in Europe (the European Union, Iceland, Liechtenstein, Norway, Switzerland, and the United Kingdom), in order to provide a comprehensive framework of cutting-edge data from all publicly available sources, regarding resistance to the three most used classes of antifungal agents (azoles, echinocandins, and polyenes).

EPI-Net's research shows that only seven national surveillance systems (from six countries) and 28 studies (from 13 countries) provided resistance data for candidemia. Azoles were reported to show the highest resistance rates, with some differences between pathogens and geographic areas, while echinocandin and polyene resistance rates were nearly zero. The surveillance systems have included a slightly increasing number of isolates over the years, yet no surveillance system or study has reported any resistance data for C. auris.

This study is especially relevant considering the publication of the Fungal Priority Pathogens' List (FPPL) by the World Health Organisation (WHO) which underlined the importance of actively monitoring fungal infections and anti-fungal resistance as a first step of the global response to this threat. This is still more evident, for example, for an emerging pathogen such as C. auris which has been recently classified among the "Critical Priority" pathogens group due to its potential to generate outbreaks and anti-fungal resistance, and for which surveillance is still lacking all over Europe.

Read the new publication here.

The EPI-Net group is currently running within the EU-funded ECRAID-Base project.