Sandven Per, Bevanger Lars, Digranes Asbjørn, Haukland Hanne H, Mannsåker Turid, Gaustad Peter
Institute of Medical Microbiology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
J Clin Microbiol. 2006 Jun;44(6):1977-81. doi: 10.1128/JCM.00029-06.
A long-term, nationwide prospective candidemia study has been ongoing in Norway since 1991. All medical microbiological laboratories in the country have participated. During the period 1991 to 2003 a total of 1,393 episodes of candidemia occurred in 1,348 patients. The incidence of candidemia episodes per 100,000 inhabitants increased from approximately 2 episodes in the early 1990s to 3 episodes in 2001 to 2003. The average annual incidences varied markedly between the age groups. The incidence was high in patients aged < 1 year and in patients aged > or = 70 years. In patients > or = 80 years of age, the incidence has increased during the last 3 years from an annual average of 6.5 to 15.6 cases/100,000 inhabitants in 2003. Four Candida species (C. albicans [70%], C. glabrata [13%], C. tropicalis [7%], and C. parapsilosis [6%]) accounted for 95.5% of the isolates. The species distribution has been constant during the 13-year study period. The distribution of the most important species varied with the age of the patient. In patients < 1 year of age, the majority of episodes were caused by C. albicans (91%). The occurrence of C. glabrata increased with age. In patients > or = 80 years of age, approximately 1/3 of all episodes were due to this species. All C. albicans strains were susceptible to fluconazole. The percentage of yeast isolates with decreased susceptibility to fluconazole (MICs > or = 16 microg/ml) was 10.7% during the first period of this study (1991 to 1996) and 11.7% during the second period (1997 to 2003).
自1991年以来，挪威一直在进行一项长期的全国性前瞻性念珠菌血症研究。该国所有医学微生物实验室均参与其中。在1991年至2003年期间，1348名患者共发生了1393次念珠菌血症发作。每10万居民中念珠菌血症发作的发生率从20世纪90年代初的约2次增加到2001年至2003年的3次。各年龄组的年均发病率差异显著。年龄<1岁的患者和年龄≥70岁的患者发病率较高。在80岁及以上的患者中，发病率在过去3年中从年均6.5例/10万居民增加到2003年的15.6例/10万居民。四种念珠菌属（白色念珠菌[70%]、光滑念珠菌[13%]、热带念珠菌[7%]和近平滑念珠菌[6%]）占分离株的95.5%。在为期13年的研究期间，菌种分布一直保持稳定。最重要的菌种分布因患者年龄而异。在<1岁的患者中，大多数发作由白色念珠菌引起（91%）。光滑念珠菌的发生率随年龄增加而上升。在80岁及以上的患者中，所有发作中约1/3归因于该菌种。所有白色念珠菌菌株对氟康唑敏感。在本研究的第一阶段（1991年至1996年），对氟康唑敏感性降低（最低抑菌浓度≥16μg/ml）的酵母菌分离株比例为10.7%，第二阶段（1997年至2003年）为11.7%。
