Candida Bloodstream Infections Surveillance

Key points

  • The Candida Bloodstream Infections Activity identifies trends and risk factors for these infections.
  • Public health professionals and healthcare providers can use this data to improve patient safety.

Overview

As part of CDC's Emerging Infections Program (EIP), the Candida Bloodstream Infections Activity:

  • Monitors epidemiologic trends in candidemia.
  • Performs species confirmation and antifungal susceptibility testing on all available Candida bloodstream isolates.

To collect this information, trained professionals review medical records for candidemia cases identified in select counties in 10 EIP states.

Public health professionals and healthcare administrators can use this data to:

  • Track incidence and monitor laboratory and epidemiologic trends, including for antifungal-resistant Candida species.
  • Identify new risk factors.
  • Communicate resistance results and trends back to submitting laboratories.
  • Understand the causes of resistance.
  • Identify areas to focus prevention and intervention strategies, including ways to improve health equity.

Highlights

Candida bloodstream infections are associated with substantial risk of death

During 2012–2016, 1 in 4 patients with candidemia died while hospitalized.

About 10% of cases occurred in patients with a history of injection drug use, mostly in younger adults. In recent years, injection drug use has become an important risk factor for candidemia.

What the data shows

Approximately 9 out of 100,000 persons developed culture-positive candidemia every year in 4 U.S. EIP sites during 2012–2016.

Groups of people more highly affected by candidemia include:

  • Adults aged 65 and older.
  • Babies less than 1 month old.
  • Black or African American persons.
  • People who inject drugs.
  • People who have had recent surgery, exposure to broad-spectrum antibiotics, or a central venous catheter

Explore the data

Access and create data visualizations

HAICViz is an interactive data dashboard that provides information included in the reports below as well as case rates and deaths over time.

Publications

See Also: NCBI Collection

About the data

Methods

EIP sites conducting surveillance

EIP site Year surveillance started Area under surveillance
California 2017 Alameda County
Colorado 2017 5 counties in metropolitan Denver
Connecticut 2019 Statewide
Georgia 2008 8 counties in metropolitan Atlanta
Maryland 2008 Baltimore City and County
Minnesota 2017 7 counties in Minneapolis-St. Paul metropolitan area
New Mexico 2017 Bernalillo County
New York 2016 Monroe County
Oregon 2011 3 counties in metropolitan Portland
Tennessee 2011 17 counties that incorporate Knoxville and surrounding areas

Case definition

When any of the following criteria are met for a patient who lives in the surveillance area:

  • A patient with a positive blood culture for any Candida species.
    • If the patient is deceased, a culture collected within 12 hours of death.
  • A patient with a new positive Candida blood culture collected greater than 30 days after the initial positive culture (this is considered a new case).

Case ascertainment

EIP surveillance staff identify candidemia cases based on positive blood cultures for Candida species reported from all inpatient and outpatient clinical laboratories serving the population within surveillance areas. Each laboratory provides reports of positive results to the local EIP site.

Data collection

Trained surveillance epidemiologists collect data at each EIP site. For each candidemia case, they review medical records to gather:

  • Demographic characteristics.
  • Location of culture collection.
  • Underlying health conditions.
  • Healthcare exposures.
  • Other risk factor information.

Laboratory characterization

Staff send incident Candida isolates collected from cases to CDC for species identification and antifungal susceptibility testing. CDC then communicates results back to submitting facilities and laboratories.

Analysis

Trained surveillance epidemiologists analyze the data to describe:

  • Changes in candidemia incidence over time.
  • Changes in molecular epidemiology including antimicrobial resistance trends.
  • Evaluate disease burden.
  • Identify health disparities.

Resources

Case report form for EIP surveillance staff

2024 Candidemia