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Volume 25, Number 9—September 2019

Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016–20171

Erika van Schalkwyk2, Ruth S. Mpembe, Juno Thomas, Liliwe Shuping, Husna Ismail, Warren Lowman, Alan S. Karstaedt, Vindana Chibabhai, Jeannette Wadula, Theunis Avenant, Angeliki Messina, Chetna N. Govind, Krishnee Moodley, Halima Dawood, Praksha Ramjathan, Nelesh P. Govender2Comments to Author , and for GERMS-SA
Author affiliations: National Institute for Communicable Diseases, Johannesburg, South Africa (E. van Schalkwyk, R.S. Mpembe, J. Thomas, L. Shuping, H. Ismail, N.P. Govender); Vermaak & Partners–Pathcare Pathologists, Johannesburg (W. Lowman); Wits Donald Gordon Medical Centre, Johannesburg (W. Lowman); University of the Witwatersrand, Johannesburg (W. Lowman, A.S. Karstaedt, V. Chibabhai, J. Wadula, A. Messina, N.P. Govender); University of Pretoria and Kalafong Provincial Tertiary Hospital, Pretoria, South Africa (T. Avenant); Netcare Hospitals Ltd, Johannesburg (A. Messina); Lancet Laboratories, Durban, South Africa (C.N. Govind, K. Moodley); University of KwaZulu-Natal, Durban (C.N. Govind, H. Dawood, P. Ramjathan); Grey’s Hospital, Pietermaritzburg, South Africa (H. Dawood); National Health Laboratory Service, Johannesburg (V. Chibabhai, J. Wadula, P. Ramjathan)

Main Article

Table 1

Incidence risk for candidemia at a limited number of public- and private-sector hospitals with available admissions data, by Candida species and healthcare sector, South Africa, 2016–2017*

Candida species No. cases at 133 hospitals Total incidence risk† (95% CI) Incidence risk at 18 public-sector hospitals† (95% CI) Incidence risk at 115 private-sector hospitals† (95% CI) Incidence risk ratio, private sector:public sector (95% CI)
C. parapsilosis
32.98 (31.3–34.6)
27.98 (24.4–31.9)
33.94 (32.2–35.8)
1.21 (1.0–1.4)
C. albicans
14.63 (13.5–15.8)
34.55 (30.6–38.9)
10.82 (98.5–11.9)
0.31 (0.2–0.4)
C. auris
12.50 (11.5–13.6)
6.93 (5.2–9.0)
13.57 (12.4–14.8)
1.96 (1.4–2.6)
C. glabrata
7.01 (6.2–7.8)
12.13 (9.8–14.8)
6.02 (5.31–6.9)
0.50 (0.3–0.7)
6.13 (5.4–6.9)
13.25 (10.8–16.1)
4.77 (4.1–5.5)
0.36 (0.2–0.5)
Total‡ 4,209 83.78 (81.2–86.4) 149.46 (141.1–158.1) 71.20 (68.6–73.8) 0.48 (0.4–0.6)

*Admissions data were available for 115 private-sector hospitals (4,216,306 admissions) and 18 public-sector hospitals (807,600 admissions).
†No. cases/100,000 hospital admissions.
‡A total of 529 candidemia cases had no Candida species identified, and incidence risk for these are not displayed in the table. However, these case numbers are included in the total number of candidemia cases and total incidence risk calculations.

Main Article

1Preliminary results from this study were presented at the Federation of Infectious Diseases Societies of Southern Africa (FIDSSA) conference (oral abstract no. 8,382), November 9–11 2017, Cape Town, South Africa.

2These authors contributed equally to this article.

Page created: August 21, 2019
Page updated: August 21, 2019
Page reviewed: August 21, 2019
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