Background: The increasing burden of candidemia and the emergence of resistance, especially among non- strains, represent a new threat for public health. We aimed to assess the status of surveillance and to identify publicly accessible resistance data in spp. blood isolates from surveillance systems and epidemiological studies in 28 European and 4 European Free Trade Association member states.
Methods: A systematic review of national and international surveillance networks, from 2015 to 2020, and peer-reviewed epidemiological surveillance studies, from 2005 to 2020, lasting for at least 12 consecutive months and with at least two centers involved, was completed to assess reporting of resistance to amphotericin B, azoles, and echinocandins in , , , , , and .
Results: Only 5 (Austria, Italy, Norway, Spain, and United Kingdom) of 32 countries provided resistance data for spp blood isolates. Among 322 surveillance studies identified, 19 were included from Belgium, Denmark, Iceland, Italy, Portugal, Spain, Sweden, Switzerland, and United Kingdom. and were the most monitored species, followed by and . was not included in any national surveillance system; 13 studies assessed resistance. No surveillance system or study reported resistance for . Fluconazole, voriconazole, caspofungin, and amphotericin B resistance in , , and were the most common drug-species combination monitored. Quality of surveillance data was poor, with only two surveillance systems reporting microbiological methods and clinical data. High heterogeneity was observed in modalities of reporting, data collection, and definitions.
Conclusion: Surveillance of antifungal resistance in spp blood-isolates is fragmented and heterogeneous, delaying the application of a translational approach to the threat of antifungal resistance and the identification of proper targets for antifungal stewardship activities. International efforts are needed to implement antifungal resistance surveillance programs in order to adequately monitor antifungal resistance.
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| http://dx.doi.org/10.3390/jof8030249 | DOI Listing |
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