Up to 82% of fungal infections worldwide were caused by Candida species in 2013, according to global surveillance conducted as part of the SENTRY Program.**20 C. albicans was consistently the predominant species, and remains responsible for the majority of candidiasis and candidaemia cases worldwide, accounting for almost 50% of Candida infections.†16,19 Recent estimates provide a range of 70-90% for global fungal infections caused by Candida across different settings.21,22
Furthermore, antifungal resistance is rising amongst Candida species, a cause for great concern with respect to managing this common IFI.23
Aspergillus infections are globally distributed and A. fumigatus is the leading cause of aspergillosis.16,24,25
Over recent years, A. flavus and A. terreus have been frequently reported in specific centres but remain uncommon in most geographic regions:26
Increasing cases of C. glabrata, C. tropicalis, C. parapsilosis, and C. krusei have been reported over the past several years.16 The rise in Aspergillus infections is a particular concern due to azole-resistant strains, which are in danger of becoming a global health threat.29
The most common species of Mucorales are the Rhizopus species, although others belonging to the order, such as Mucor, Rhizomucor, Lichtheimia, Mycocladus, Apophysomyces, Saksenaea, Cunninghamella, Cokeromyces and Syncephalastrum, have been reported.24
The classical risk factors for mucormycosis are uncontrolled diabetes and injuries or wounds in the skin; however, immunosuppression and granulocytopenia have become the most common predisposing factors in many tertiary hospitals over recent years.24
In Brazil, Fusarium species have become a leading cause of invasive fungal disease in haematological patients and may be the second most common nosocomial fungal pathogen after Aspergillus in some tertiary hospitals.24 Fusarium solani is the most common and virulent species, comprising approximately 40-60% of infections globally.47 Additionally, treatment poses challenges as a higher level of antifungal resistance has been observed in Fusarium vs. Aspergillus species.24
Stay one step ahead of IFIs by understanding their strengths, weaknesses, and target patients.
*The SENTRY global antifungal surveillance programme was established to monitor the predominant pathogens and antimicrobial resistance patterns of nosocomial and community-onset infections. Clinical isolates were collected from 39 countries across the globe under the following objectives: bloodstream, skin and skin structure, respiratory, urinary tract, intra-abdominal and IFIs, as well as pathogens from patients hospitalised with pneumonia.19
**A total of 1846 clinical isolates were collected as part of a global surveillance during 2013. Among those, 1514 (82.0%) were Candida species, 114 (6.2%) were noncandidal yeasts including cryptococcus neoformans (84, 4.5%), 196 (10.6%) were Aspergillus species and 22 (1.2%) were other moulds. Isolates were geographically distributed among Europe (41.0%), the Asia-Pacific (24.5%), North America (23.5%) and Latin America (11.0%).20
†Among the 20,788 Candida isolates submitted for testing as part of the SENTRY Program from 1997-2016, 46.9% were C. albicans, 18.7% were C. glabrata, 15.9% were C. parapsilosis, 9.3% were C. tropicalis, 2.8% were C. krusei and 6.5% were miscellaneous Candida species. The rank order of the 5 most common species varied slightly over time, although C. albicans was the predominant species every year.19
Date of preparation: November 2022. Job code IHQ-AMB-0793.