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Differences in epidemiology of candidaemia in the Nordic countries - what is to blame?
Research institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, Norway; Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway.
Unit of mycology, Department of Microbiology and Research, Statens Serum Institute, Copenhagen, Denmark.
Department of Haematology, Helsinki University Central Hospital, Helsinki, Finland.
Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.
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2017 (English)In: Mycoses, ISSN 0933-7407, E-ISSN 1439-0507, Vol. 60, no 1, p. 11-19Article in journal (Refereed) Published
Abstract [en]

National data from Denmark, Finland, Norway and Sweden demonstrate remarkable differences in candidaemia epidemiology. Only Denmark has reported a high incidence of 10 per 100 000 inhabitants and a species shift towards increased C. glabrata candidaemias. The reasons for this development remain unclear. The aim of this study was to explore possible contributing factors for the differences in Candida epidemiology in the Nordic countries. We used public data from 2011 from Denmark, Finland, Norway and Sweden on epidemiology, demographics, health facilities, predisposing risk factors, consumption of antimicrobial drugs and fungicides in agricultural industry. Only the prevalence of haematological malignancies (P < 0.001) was significantly higher in Denmark compared to the other Nordic countries. The antibacterial drug use of metronidazole, piperacillin-tazobactam, ciprofloxacin, colistin and carbapenems, and antifungal use of fluconazole in humans (P < 0.001), were significantly higher in Denmark compared to the other Nordic countries (all P < 0.001). Our findings suggest haematological malignancy, the use of certain antibacterial drugs and azoles in humans as possible contributing factors for the differences in Candida epidemiology. However, our results should be interpreted with caution due to the lack of long-term, case-specific data. Further studies are needed.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017. Vol. 60, no 1, p. 11-19
Keywords [en]
Candidaemia; Nordic countries; antifungal consumption; prescription practice
National Category
Infectious Medicine Clinical Laboratory Medicine
Identifiers
URN: urn:nbn:se:liu:diva-192788DOI: 10.1111/myc.12535PubMedID: 27464892OAI: oai:DiVA.org:liu-192788DiVA, id: diva2:1747925
Available from: 2023-03-31 Created: 2023-03-31 Last updated: 2023-03-31

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Serrander, Lena

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Division of Inflammation and InfectionFaculty of Medicine and Health SciencesDepartment of Clinical Microbiology
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