, Volume 47, Issue 2, pp 209–216 | Cite as

Increasing incidence of candidaemia and shifting epidemiology in favor of Candida non-albicans in a 9-year period (2009–2017) in a university Greek hospital

  • Matthaios Papadimitriou-Olivgeris
  • Anastasia Spiliopoulou
  • Fevronia Kolonitsiou
  • Christina Bartzavali
  • Anastasia Lambropoulou
  • Panagiota Xaplanteri
  • Evangelos D. Anastassiou
  • Markos Marangos
  • Iris Spiliopoulou
  • Myrto ChristofidouEmail author
Original Paper



The aim of the present study was to analyze candidaemia’s epidemiology (incidence, species distribution, and susceptibility rates) and antifungal consumption during a 9-year period.


All candidaemias recorded at The University General Hospital of Patras, Greece, between 2009 and 2017 were included. Candida isolates were identified using the germ tube test, API 20C AUX System, and/or Vitek-2 YST card. Antifungal susceptibility was determined by the gradient method according to CLSI.


During the study period, 505 episodes of candidaemia were observed with an overall incidence of 1.5 episodes per 1000 hospital admissions (1.1 episodes in 2009 to 1.9 in 2017: P 0.038, r 0.694). C. albicans was the leading cause (200 cases; 39.6%), followed by C. parapsilosis (185; 36.6%), C. glabrata (56; 11.1%), C. tropicalis (50; 9.9%), C. krusei (8; 0.2%), C. lusitaniae (5; < 0.1%), and C. guilliermondii (1; < 0.1%). Overall resistance to fluconazole, voriconazole, anidulafungin, caspofungin, and micafungin (according to CLSI) were 11.6%, 4.1%, 2.0%, 6.0%, and 0.8%, respectively. The overall consumption of antifungal drugs was stable, with a significant reduction of fluconazole’s use in favor of echinocandins.


An increase in the incidence of candidaemia and a predominance of Candida non-albicans due to decreasing use of fluconazole in favor of more potent antifungals, such as echinocandins, are reported in this study.


Candidaemia Echinocandins Fluconazole Antifungal consumption 



This study was supported by funds of the Department of Microbiology, School of Medicine, University of Patras.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The study was approved by the Bioethics’ Committee of the UGHP (no. 3324).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Matthaios Papadimitriou-Olivgeris
    • 1
    • 3
  • Anastasia Spiliopoulou
    • 2
  • Fevronia Kolonitsiou
    • 2
  • Christina Bartzavali
    • 2
  • Anastasia Lambropoulou
    • 2
  • Panagiota Xaplanteri
    • 2
  • Evangelos D. Anastassiou
    • 2
  • Markos Marangos
    • 1
  • Iris Spiliopoulou
    • 2
  • Myrto Christofidou
    • 2
    Email author
  1. 1.Division of Infectious Diseases, Department of Internal Medicine, School of MedicineUniversity of PatrasPatrasGreece
  2. 2.Department of Microbiology, School of MedicineUniversity of PatrasPatrasGreece
  3. 3.Department of Infectious DiseasesUniversity Hospital of LausanneLausanneSwitzerland

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