Global and Regional Burden of bloodstream infection caused by Candida spp. from 1990-2021: A Systematic Analysis and Future Projections

PurposeThis study aimed to assess and predict the global and regional burden of candidemia. MethodsWe extracted data on the estimated burden of candidemia from 1990 to 2021 from the MICROBE database. The number of deaths, age-standardized mortality of rate(ASMR) and disability-adjusted life-years(DALYs) associated with candidemia, were systematically analyzed. The burden of candidemia over the next 30 years was predicted using the Bayesian age-period-cohort model with integrated nested Laplace approximations. ResultsIn 2021, candidemia accounted for approximately 174,716 deaths(95% UI, 159,876-189,556) globally, with an ASMR of 2.28 (95% UI, 2.06-2.50) per 100k population. The highest burden of candidemia was observed in Southern, Western, and Eastern Sub-Saharan Africa, while the lowest burden occurred in High-income Asia Pacific, Australasia, and Western Europe. Males and older adults exhibited a higher disease burden, while the under-5 age group also demonstrated a substantial burden. Projections indicated that the mortality rate of candidemia was expected to decline to 1.72 per 100k(95% UI: 1.45-2.00) by 2050. ConclusionsOur findings underscore the significant global burden of candidemia, with notable regional disparities. Addressing this burden requires enhanced surveillance, robust antifungal stewardship programs, targeted interventions for high-risk populations, and improved diagnostic and therapeutic capabilities to mitigate the impact of antifungal resistance and reduce mortality.