Data and Statistics on Candidemia

At a glance

  • Candidemia is a bloodstream infection caused by the fungus Candida.
  • Candidemia is one of the most common bloodstream infections in the United States.
  • An estimated 25,000 cases of candidemia occur in the United States each year.
  • Candidemia is associated with high rates of death.
map showing Emerging Infections Program sites

Candidemia

Hospitalized patients, typically those who are very sick, can get invasive candidiasis, Candida infections in their bloodstream, joints, or organs. Candidemia refers specifically to bloodstream infections with Candida, the most common type of invasive infections.

Additionally, candidemia is one of the most common bloodstream infections in the US.1 Surgical wounds and invasive medical devices like catheters, central venous lines, and ventilators create opportunities for Candida to enter the body.

Separate data for Candida auris (C. auris)‎

Candida auris is a species of Candida that is covered separately and is a nationally notifiable disease.

Candidemia surveillance

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

  • Monitors epidemiologic trends in candidemia.
  • Performs species confirmation.
  • Conducts antifungal susceptibility testing.
Keep Reading: Candida Bloodstream Infections Activity

To collect this information, trained professionals conduct active population- and laboratory-based surveillance in 10 EIP sites.

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Map highlighting the ten states that conduct candidemia surveillance for EIP
EIP candidemia sites; dark green are counties under surveillance.

Healthcare-associated infection surveillance

ob体育 also collects data on healthcare-associated infections, including central line-associated Candida infections, through the National Healthcare Safety Network (NHSN), the largest healthcare-associated infection reporting system in the United States.

Candidemia trends

National trends

An estimated 25,000 cases of candidemia occur in the United States each year.2

Candidemia incidence declined during 2008–2013 and then remained at approximately 9 cases per 100,000 population per year during 2012–2016.34

Improvements in healthcare delivery, including catheter care and maintenance, may explain these lower rates.3

Mortality

About 25% of people with candidemia die during hospitalization (crude mortality rate), according to ob体育 surveillance. However, candidemia tends to affect patients who are already very sick so it is often difficult to determine whether candidemia is the cause of death versus other medical factors.

One study compared patients with candidemia to patients without candidemia who had similar illnesses. The results indicated that candidemia was the cause of about 19%-24% of deaths among infected patients.5

Injection drug use

Although the overall national incidence has declined, incidence increased in some surveillance areas in recent years. This may be due to the growing number of cases linked to injection drug use.678 From 2012-2016, about 10% of cases occurred in patients with a history of injection drug use, mostly in younger adults.4

HAICViz‎

HAICViz is an interactive tool that displays trends in candidemia incidence, outcomes, species distribution, and antimicrobial resistance patterns using data collected through EIP.

Species distribution and antimicrobial resistance

Trends in species distribution

Up to 95% of all Candida bloodstream infections in the United States are caused by five species of Candida: C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei. The proportion of infections caused by each species varies by geographic region and by patient population.9

  • Overall, C. albicans is the leading cause of candidemia.
  • Infections with antifungal-resistant non-albicans are increasing.101112
  • Non-albicans species cause approximately two-thirds of cases.310
  • In some locations, C. glabrata is the most common species.

Trends in antimicrobial resistance

Some types of Candida are increasingly resistant to first-line and second-line antifungal medications. These antifungals include fluconazole and echinocandins (anidulafungin, caspofungin, and micafungin).

Fluconazole resistance

About 7% of all Candida bloodstream isolates tested at ob体育 are resistant to fluconazole. More than 70% of these resistant isolates are the species C. glabrata or C. krusei.1013 ob体育's surveillance data indicate that the proportion of Candida isolates resistant to fluconazole has remained fairly constant over the past 20 years.101415

Echinocandin resistance

Echinocandin resistance appears to be emerging, especially among C. glabrata isolates. Approximately 3% of C. glabrata isolates are resistant to echinocandins, but the percentage may be higher in some hospitals. Echinocandins are the first-line treatment for C. glabrata, which already has high levels of resistance to fluconazole.13

Populations

The decreased rates of candidemia are most notable among infant and elderly populations.1617

Among all ages, candidemia rates are approximately twice as high among Black people compared with other races/ethnicities. The differences by race might be due to differences in underlying conditions, socioeconomic status, healthcare access and availability, or other factors.

Learn more about candidemia incidence rates by age group and race.

Impacts

Leading cause of healthcare-associated bloodstream infections

Candida is a leading cause of healthcare-associated bloodstream infections in U.S. hospitals. Invasive Candida infections are costly for patients and healthcare facilities because of the long hospital stays. According to estimates, each case requires about 3 to 13 additional days of hospitalization and $6,000 to $29,000 in healthcare costs.5

Outbreaks and clusters

Most cases of invasive candidiasis are not associated with outbreaks. However, periodic outbreaks of C. parapsilosis infection have been reported for decades. This includes clusters in neonatal intensive care units, likely transmitted via healthcare workers' hands.181920

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
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  • Candida auris is more transmissible than other Candida species and is associated with outbreaks in healthcare facilities.