European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study

Maiken Cavling Arendrup; Sevtap Arikan-Akdagli; Karin Meinike Jørgensen; Aleksandra Barac; Jörg Steinmann; Cristina Toscano; Valentina Arsic Arsenijevic; Assunta Sartor; Cornelia Lass-Flörl; Axel Hamprecht; Tadeja Matos; Benedict R.S. Rogers; Inmaculada Quiles; Jochem Buil; Volkan Özenci; Robert Krause; Matteo Bassetti; Laura Loughlin; Blandine Denis; Anna Grancini; P. Lewis White; Katrien Lagrou; Birgit Willinger; Riina Rautemaa-Richardson; Petr Hamal; Beyza Ener; Tugce Unalan-Altintop; Ebru Evren; Suleyha Hilmioglu-Polat; Yasemin Oz; Ozlem Koyuncu Ozyurt; Faruk Aydin; Filip Růžička; Eelco F.J. Meijer; Jean Pierre Gangneux; Deborah E.A. Lockhart; Nina Khanna; Clare Logan; Ulrike Scharmann; Guillaume Desoubeaux; Emmanuel Roilides; Alida Fe Talento; Karin van Dijk; Philipp Koehler; Jon Salmanton-García; Oliver A. Cornely; Martin Hoenigl

doi:10.1016/j.jinf.2023.08.001

European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study

Maiken Cavling Arendrup^*, Sevtap Arikan-Akdagli, Karin Meinike Jørgensen, Aleksandra Barac, Jörg Steinmann, Cristina Toscano, Valentina Arsic Arsenijevic, Assunta Sartor, Cornelia Lass-Flörl, Axel Hamprecht, Tadeja Matos, Benedict R.S. Rogers, Inmaculada Quiles, Jochem Buil, Volkan Özenci, Robert Krause, Matteo Bassetti, Laura Loughlin, Blandine Denis, Anna GranciniP. Lewis White, Katrien Lagrou, Birgit Willinger, Riina Rautemaa-Richardson, Petr Hamal, Beyza Ener, Tugce Unalan-Altintop, Ebru Evren, Suleyha Hilmioglu-Polat, Yasemin Oz, Ozlem Koyuncu Ozyurt, Faruk Aydin, Filip Růžička, Eelco F.J. Meijer, Jean Pierre Gangneux, Deborah E.A. Lockhart, Nina Khanna, Clare Logan, Ulrike Scharmann, Guillaume Desoubeaux, Emmanuel Roilides, Alida Fe Talento, Karin van Dijk, Philipp Koehler, Jon Salmanton-García, Oliver A. Cornely, Martin Hoenigl

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence.

Original language	English
Journal	Journal of Infection
Volume	87
Issue number	5
Pages (from-to)	428-437
Number of pages	10
ISSN	0163-4453
DOIs	https://doi.org/10.1016/j.jinf.2023.08.001
Publication status	Published - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Author(s)

Keywords

C. parapsilosis
Candida
Echinocandin resistance
EUCAST
Fks1
Fluconazole resistance

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Arendrup, M. C., Arikan-Akdagli, S., Jørgensen, K. M., Barac, A., Steinmann, J., Toscano, C., Arsenijevic, V. A., Sartor, A., Lass-Flörl, C., Hamprecht, A., Matos, T., Rogers, B. R. S., Quiles, I., Buil, J., Özenci, V., Krause, R., Bassetti, M., Loughlin, L., Denis, B., ... Hoenigl, M. (2023). European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study. Journal of Infection, 87(5), 428-437. https://doi.org/10.1016/j.jinf.2023.08.001

European candidaemia is characterised by notable differential epidemiology and susceptibility pattern : Results from the ECMM Candida III study. / Arendrup, Maiken Cavling; Arikan-Akdagli, Sevtap; Jørgensen, Karin Meinike; Barac, Aleksandra; Steinmann, Jörg; Toscano, Cristina; Arsenijevic, Valentina Arsic; Sartor, Assunta; Lass-Flörl, Cornelia; Hamprecht, Axel; Matos, Tadeja; Rogers, Benedict R.S.; Quiles, Inmaculada; Buil, Jochem; Özenci, Volkan; Krause, Robert; Bassetti, Matteo; Loughlin, Laura; Denis, Blandine; Grancini, Anna; White, P. Lewis; Lagrou, Katrien; Willinger, Birgit; Rautemaa-Richardson, Riina; Hamal, Petr; Ener, Beyza; Unalan-Altintop, Tugce; Evren, Ebru; Hilmioglu-Polat, Suleyha; Oz, Yasemin; Ozyurt, Ozlem Koyuncu; Aydin, Faruk; Růžička, Filip; Meijer, Eelco F.J.; Gangneux, Jean Pierre; Lockhart, Deborah E.A.; Khanna, Nina; Logan, Clare; Scharmann, Ulrike; Desoubeaux, Guillaume; Roilides, Emmanuel; Talento, Alida Fe; van Dijk, Karin; Koehler, Philipp; Salmanton-García, Jon; Cornely, Oliver A.; Hoenigl, Martin.

In: Journal of Infection, Vol. 87, No. 5, 2023, p. 428-437.

Research output: Contribution to journal › Journal article › Research › peer-review

Arendrup, MC, Arikan-Akdagli, S, Jørgensen, KM, Barac, A, Steinmann, J, Toscano, C, Arsenijevic, VA, Sartor, A, Lass-Flörl, C, Hamprecht, A, Matos, T, Rogers, BRS, Quiles, I, Buil, J, Özenci, V, Krause, R, Bassetti, M, Loughlin, L, Denis, B, Grancini, A, White, PL, Lagrou, K, Willinger, B, Rautemaa-Richardson, R, Hamal, P, Ener, B, Unalan-Altintop, T, Evren, E, Hilmioglu-Polat, S, Oz, Y, Ozyurt, OK, Aydin, F, Růžička, F, Meijer, EFJ, Gangneux, JP, Lockhart, DEA, Khanna, N, Logan, C, Scharmann, U, Desoubeaux, G, Roilides, E, Talento, AF, van Dijk, K, Koehler, P, Salmanton-García, J, Cornely, OA & Hoenigl, M 2023, 'European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study', Journal of Infection, vol. 87, no. 5, pp. 428-437. https://doi.org/10.1016/j.jinf.2023.08.001

Arendrup, Maiken Cavling ; Arikan-Akdagli, Sevtap ; Jørgensen, Karin Meinike ; Barac, Aleksandra ; Steinmann, Jörg ; Toscano, Cristina ; Arsenijevic, Valentina Arsic ; Sartor, Assunta ; Lass-Flörl, Cornelia ; Hamprecht, Axel ; Matos, Tadeja ; Rogers, Benedict R.S. ; Quiles, Inmaculada ; Buil, Jochem ; Özenci, Volkan ; Krause, Robert ; Bassetti, Matteo ; Loughlin, Laura ; Denis, Blandine ; Grancini, Anna ; White, P. Lewis ; Lagrou, Katrien ; Willinger, Birgit ; Rautemaa-Richardson, Riina ; Hamal, Petr ; Ener, Beyza ; Unalan-Altintop, Tugce ; Evren, Ebru ; Hilmioglu-Polat, Suleyha ; Oz, Yasemin ; Ozyurt, Ozlem Koyuncu ; Aydin, Faruk ; Růžička, Filip ; Meijer, Eelco F.J. ; Gangneux, Jean Pierre ; Lockhart, Deborah E.A. ; Khanna, Nina ; Logan, Clare ; Scharmann, Ulrike ; Desoubeaux, Guillaume ; Roilides, Emmanuel ; Talento, Alida Fe ; van Dijk, Karin ; Koehler, Philipp ; Salmanton-García, Jon ; Cornely, Oliver A. ; Hoenigl, Martin. / European candidaemia is characterised by notable differential epidemiology and susceptibility pattern : Results from the ECMM Candida III study. In: Journal of Infection. 2023 ; Vol. 87, No. 5. pp. 428-437.

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abstract = "The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence.",

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author = "Arendrup, {Maiken Cavling} and Sevtap Arikan-Akdagli and J{\o}rgensen, {Karin Meinike} and Aleksandra Barac and J{\"o}rg Steinmann and Cristina Toscano and Arsenijevic, {Valentina Arsic} and Assunta Sartor and Cornelia Lass-Fl{\"o}rl and Axel Hamprecht and Tadeja Matos and Rogers, {Benedict R.S.} and Inmaculada Quiles and Jochem Buil and Volkan {\"O}zenci and Robert Krause and Matteo Bassetti and Laura Loughlin and Blandine Denis and Anna Grancini and White, {P. Lewis} and Katrien Lagrou and Birgit Willinger and Riina Rautemaa-Richardson and Petr Hamal and Beyza Ener and Tugce Unalan-Altintop and Ebru Evren and Suleyha Hilmioglu-Polat and Yasemin Oz and Ozyurt, {Ozlem Koyuncu} and Faruk Aydin and Filip Rů{\v z}i{\v c}ka and Meijer, {Eelco F.J.} and Gangneux, {Jean Pierre} and Lockhart, {Deborah E.A.} and Nina Khanna and Clare Logan and Ulrike Scharmann and Guillaume Desoubeaux and Emmanuel Roilides and Talento, {Alida Fe} and {van Dijk}, Karin and Philipp Koehler and Jon Salmanton-Garc{\'i}a and Cornely, {Oliver A.} and Martin Hoenigl",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

doi = "10.1016/j.jinf.2023.08.001",

language = "English",

volume = "87",

pages = "428--437",

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TY - JOUR

T1 - European candidaemia is characterised by notable differential epidemiology and susceptibility pattern

T2 - Results from the ECMM Candida III study

AU - Arendrup, Maiken Cavling

AU - Arikan-Akdagli, Sevtap

AU - Jørgensen, Karin Meinike

AU - Barac, Aleksandra

AU - Steinmann, Jörg

AU - Toscano, Cristina

AU - Arsenijevic, Valentina Arsic

AU - Sartor, Assunta

AU - Lass-Flörl, Cornelia

AU - Hamprecht, Axel

AU - Matos, Tadeja

AU - Rogers, Benedict R.S.

AU - Quiles, Inmaculada

AU - Buil, Jochem

AU - Özenci, Volkan

AU - Krause, Robert

AU - Bassetti, Matteo

AU - Loughlin, Laura

AU - Denis, Blandine

AU - Grancini, Anna

AU - White, P. Lewis

AU - Lagrou, Katrien

AU - Willinger, Birgit

AU - Rautemaa-Richardson, Riina

AU - Hamal, Petr

AU - Ener, Beyza

AU - Unalan-Altintop, Tugce

AU - Evren, Ebru

AU - Hilmioglu-Polat, Suleyha

AU - Oz, Yasemin

AU - Ozyurt, Ozlem Koyuncu

AU - Aydin, Faruk

AU - Růžička, Filip

AU - Meijer, Eelco F.J.

AU - Gangneux, Jean Pierre

AU - Lockhart, Deborah E.A.

AU - Khanna, Nina

AU - Logan, Clare

AU - Scharmann, Ulrike

AU - Desoubeaux, Guillaume

AU - Roilides, Emmanuel

AU - Talento, Alida Fe

AU - van Dijk, Karin

AU - Koehler, Philipp

AU - Salmanton-García, Jon

AU - Cornely, Oliver A.

AU - Hoenigl, Martin

PY - 2023

Y1 - 2023

N2 - The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence.

AB - The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence.

KW - C. parapsilosis

KW - Candida

KW - Echinocandin resistance

KW - EUCAST

KW - Fks1

KW - Fluconazole resistance

U2 - 10.1016/j.jinf.2023.08.001

DO - 10.1016/j.jinf.2023.08.001

M3 - Journal article

C2 - 37549695

AN - SCOPUS:85170210574

VL - 87

SP - 428

EP - 437

JO - Journal of Infection

JF - Journal of Infection

SN - 0163-4453

IS - 5

ER -