Changing Epidemiology of Clinical Isolates of <i>Candida</i> Species during the Coronavirus Disease 2019 Pandemic: Data Analysis from a Korean Tertiary Care Hospital for 6 Years (2017–2022)

This study assessed the changes in <i>Candida</i> species distribution and antifungal susceptibility patterns during the coronavirus disease 2019 (COVID-19) pandemic compared with a pre-pandemic period in Korea. We retrospectively investigated the specimen, species type, and antifungal s...

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Main Authors: Eun Jeong Won, Heungsup Sung, Mi-Na Kim
Format: Article
Language:English
Published: MDPI AG 2024-03-01
Series:Journal of Fungi
Subjects:
Online Access:https://www.mdpi.com/2309-608X/10/3/193
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author Eun Jeong Won
Heungsup Sung
Mi-Na Kim
author_facet Eun Jeong Won
Heungsup Sung
Mi-Na Kim
author_sort Eun Jeong Won
collection DOAJ
description This study assessed the changes in <i>Candida</i> species distribution and antifungal susceptibility patterns during the coronavirus disease 2019 (COVID-19) pandemic compared with a pre-pandemic period in Korea. We retrospectively investigated the specimen, species type, and antifungal susceptibility of <i>Candida</i> isolates obtained between 2016 and 2022. Data between two periods were compared: 2016–2019 (pre-pandemic) and 2020–2022 (pandemic). We included 11,396 clinical isolates of <i>Candida</i> species (5137 isolates in the pre-pandemic and 6259 isolates in the pandemic). The most prevalent species was <i>Candida albicans</i> (50.4%), followed by <i>Candida glabrata</i> (22.7%), <i>Candida tropicalis</i> (12.5%), and <i>Candida parapsilosis</i> complex (12.5%). Their ranks were unchanged; however, their relative isolation ratios varied during the pandemic, exhibiting differences ranging from 0.4 to 2.5 across species. The incidence of candidemia increased during the pandemic (average 1.79 episodes per 10,000 patient days) compared with pre-pandemic levels (average 1.45 episodes per 10,000 patient days) in both intensive-care-unit (ICU) and non-ICU patients. Additionally, <i>C. parapsilosis</i> complex candidemia increased by 1.6-fold during the pandemic. During the pandemic, <i>C. albicans</i> and <i>C. tropicalis</i> candidemia significantly increased by 1.5- and 1.4-fold in ICU patients. In contrast, <i>C. parapsilosis</i> complex candidemia surged 2.1-fold in non-ICU patients. These species exhibited reduced resistance to fluconazole, voriconazole, caspofungin, and micafungin in the pandemic compared with the pre-pandemic. This study underscores the heightened incidence of <i>Candida</i>-related infections during the COVID-19 pandemic and emphasizes the importance of ongoing surveillance of <i>Candida</i> species epidemiology beyond the pandemic’s scope.
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spelling doaj.art-2c3448f050ad4975a02264b9dd16c2912024-03-27T13:49:40ZengMDPI AGJournal of Fungi2309-608X2024-03-0110319310.3390/jof10030193Changing Epidemiology of Clinical Isolates of <i>Candida</i> Species during the Coronavirus Disease 2019 Pandemic: Data Analysis from a Korean Tertiary Care Hospital for 6 Years (2017–2022)Eun Jeong Won0Heungsup Sung1Mi-Na Kim2Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of KoreaDepartment of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of KoreaDepartment of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of KoreaThis study assessed the changes in <i>Candida</i> species distribution and antifungal susceptibility patterns during the coronavirus disease 2019 (COVID-19) pandemic compared with a pre-pandemic period in Korea. We retrospectively investigated the specimen, species type, and antifungal susceptibility of <i>Candida</i> isolates obtained between 2016 and 2022. Data between two periods were compared: 2016–2019 (pre-pandemic) and 2020–2022 (pandemic). We included 11,396 clinical isolates of <i>Candida</i> species (5137 isolates in the pre-pandemic and 6259 isolates in the pandemic). The most prevalent species was <i>Candida albicans</i> (50.4%), followed by <i>Candida glabrata</i> (22.7%), <i>Candida tropicalis</i> (12.5%), and <i>Candida parapsilosis</i> complex (12.5%). Their ranks were unchanged; however, their relative isolation ratios varied during the pandemic, exhibiting differences ranging from 0.4 to 2.5 across species. The incidence of candidemia increased during the pandemic (average 1.79 episodes per 10,000 patient days) compared with pre-pandemic levels (average 1.45 episodes per 10,000 patient days) in both intensive-care-unit (ICU) and non-ICU patients. Additionally, <i>C. parapsilosis</i> complex candidemia increased by 1.6-fold during the pandemic. During the pandemic, <i>C. albicans</i> and <i>C. tropicalis</i> candidemia significantly increased by 1.5- and 1.4-fold in ICU patients. In contrast, <i>C. parapsilosis</i> complex candidemia surged 2.1-fold in non-ICU patients. These species exhibited reduced resistance to fluconazole, voriconazole, caspofungin, and micafungin in the pandemic compared with the pre-pandemic. This study underscores the heightened incidence of <i>Candida</i>-related infections during the COVID-19 pandemic and emphasizes the importance of ongoing surveillance of <i>Candida</i> species epidemiology beyond the pandemic’s scope.https://www.mdpi.com/2309-608X/10/3/193COVID-19 pandemic<i>Candida</i> speciescandidemia<i>C. parapsilosis</i>
spellingShingle Eun Jeong Won
Heungsup Sung
Mi-Na Kim
Changing Epidemiology of Clinical Isolates of <i>Candida</i> Species during the Coronavirus Disease 2019 Pandemic: Data Analysis from a Korean Tertiary Care Hospital for 6 Years (2017–2022)
Journal of Fungi
COVID-19 pandemic
<i>Candida</i> species
candidemia
<i>C. parapsilosis</i>
title Changing Epidemiology of Clinical Isolates of <i>Candida</i> Species during the Coronavirus Disease 2019 Pandemic: Data Analysis from a Korean Tertiary Care Hospital for 6 Years (2017–2022)
title_full Changing Epidemiology of Clinical Isolates of <i>Candida</i> Species during the Coronavirus Disease 2019 Pandemic: Data Analysis from a Korean Tertiary Care Hospital for 6 Years (2017–2022)
title_fullStr Changing Epidemiology of Clinical Isolates of <i>Candida</i> Species during the Coronavirus Disease 2019 Pandemic: Data Analysis from a Korean Tertiary Care Hospital for 6 Years (2017–2022)
title_full_unstemmed Changing Epidemiology of Clinical Isolates of <i>Candida</i> Species during the Coronavirus Disease 2019 Pandemic: Data Analysis from a Korean Tertiary Care Hospital for 6 Years (2017–2022)
title_short Changing Epidemiology of Clinical Isolates of <i>Candida</i> Species during the Coronavirus Disease 2019 Pandemic: Data Analysis from a Korean Tertiary Care Hospital for 6 Years (2017–2022)
title_sort changing epidemiology of clinical isolates of i candida i species during the coronavirus disease 2019 pandemic data analysis from a korean tertiary care hospital for 6 years 2017 2022
topic COVID-19 pandemic
<i>Candida</i> species
candidemia
<i>C. parapsilosis</i>
url https://www.mdpi.com/2309-608X/10/3/193
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