This new piece of research is the output of a thorough work by the EPI-NET team, including researchers from Università degli Studi di Verona and Universitätklinikum Tübingen der Eberhard-Karl-Universität, who worked enthusiastically on updating the current knowledge regarding bloodstream infections by fungi of the Candida genus.
The ID-CARE UniVR team, coordinated by Prof. Evelina Tacconelli, is heavily involved in EPI-Net – an international network of epidemiology experts established within the COMBACTE-MAGNET project and currently running within the EU-funded ECRAID-Base project. Since 2017, the EPI-Net research team has been working to provide a continuously updated repository of surveillance data regarding bacterial antimicrobial resistance (AMR), healthcare-related infections (HAIs), fungal bloodstream infections (candidemiae), outbreaks from resistant pathogens, and emerging resistances to newly approved antibiotics in Europe.
Specifically, this study includes a comprehensive review of the latest data on candidemia and antifungal resistance rates for six pathogens: C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, and C. auris. Following the EPI-Net protocol, journal publications and surveillance systems have been inspected across 32 countries in Europe (the European Union, Iceland, Liechtenstein, Norway, Switzerland, and the United Kingdom), in order to provide a comprehensive framework of cutting-edge data from all publicly available sources, regarding resistance to the three most used classes of antifungal agents (azoles, echinocandins, and polyenes).
The study shows that only 7 national surveillance systems (from 6 countries) and 28 studies (from 13 countries) provided resistance data for candidemia. Azoles were reported to show the highest resistance rates, with some differences between pathogens and geographic areas, while echinocandin and polyene resistance rates were nearly zero. The surveillance systems have included a slightly increasing number of isolates over the years, yet no surveillance system or study has reported any resistance data for C. auris.
This study is relevant, especially considering the publication of the Fungal Priority Pathogens' List (FPPL) by the World Health Organisation (WHO), which underlined the importance of actively monitoring fungal infections and antifungal resistance as a first step of the global response to this threat: this is still more evident, for example, for an emerging pathogen such as C. auris, which has been recently classified among the "Critical Priority" pathogens group due to its potential to generate outbreaks and antifungal resistance, and for which surveillance is still lacking all over Europe.
👉 Link to the article (Journal of Fungi): https://doi.org/10.3390/jof10100685
A big thank you to all the authors for this fruitful, trans-national collaboration involving current and former EPI-Net researchers from the universities of Verona and Tübingen: Karin Odoj, Jacopo Garlasco, Maria Diletta Pezzani, Cristina Magnabosco, Diego Ortiz, Federica Manco, Liliana Galia, Sarah K. Foster, Fabiana Arieti, Evelina Tacconelli
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