Incidence, susceptibility and outcomes of candidemia in adults living in Calgary, Alberta, Canada (2010-2018)

Background Candidemia is increasing in frequency and is associated with high mortality. We sought to determine the burden of illness, the population it affects and its resistance profile in our region. Methods The Calgary Zone (CZ) provides all care for residents of Calgary and surrounding communities (similar to 1.69 million) via five tertiary hospitals each served by a common single laboratory for acute care microbiology. All adult patients in the CZ with at least one Candida spp.-positive blood culture between January 1, 2010, and December 31, 2018, were identified using microbiological data from Calgary Lab Services, the laboratory that processes > 95% of all blood culture samples in the CZ, were reviewed for the study. Results The overall annual incidence of candidemia among individuals living in the CZ was 3.8 per 100,000 persons (Median age 61 years (IQR 48-72) and 221/455 (47.4%) were female). C. albicans was the most common species (50.6%), followed by C. glabrata, (24.0%). No other species accounted for more than 7% of cases. Overall mortality at 30, 90, and 365 days was 32.2, 40.1, and 48.1% respectively. Mortality rate did not differ by Candida species. Of individuals who developed candidemia, more than 50% died within the next year. No new resistance pattern has emerged in the most common Candida species in Calgary, Alberta. Conclusions In Calgary, Alberta, the incidence of candidemia has not increased in the last decade. C. albicans was the most common species and it remains susceptible to fluconazole.

Automated summary

This study aimed to determine the burden of illness, the population it affects, and the resistance profile of candidemia in our region. The annual incidence of candidemia in the Calgary Region was 3.8 per 100,000 persons, with C. albicans being the most common species. More than 50% of individuals with candidemia died within a year. The common Candida species in Calgary remains susceptible to fluconazole.