Evaluation of Candidemia Cases

Abstract

Systemic candida infections are becoming more important day by day. Candidemia is an important cause of morbidity and mortality in all critically ill patients, especially the immunocompromised group. In this study, we aimed to investigate the incidence, demographic data, risk factors, fungal species, antifungal susceptibilities and clinical results of patients with candidemia in our hospital. The patients diagnosed with candidemia in Uşak Education and Research Hospital between January 1, 2017, and December 31, 2018, were evaluated retrospectively. In the two-year period, 45 episodes of candidemia were detected in 45 patients. The mean age of the patients was 70.91 ± 13.44 and 23 (51%) of the patients were male. Candidemia incidences per 1000 patients admitted to the hospital and ICUs were determined as 0.47 and 3.67 respectively. The most common risk factors for the development of candidemia were the use of broad-spectrum antibiotics (93.3%), presence of urinary catheter (93.3%), total parenteral nutrition (80%), ICU admission (73.3%), mechanical ventilation and intubation (73.3%). Among the isolated Candida species, 31 (69%) were identified as C. albicans, while the others were non-albicans Candida strains. Three C. albicans strains were resistant to fluconazole and two showed decreased sensitivity. Two of the C. glabrata strains also had decreased sensitivity to fluconazole. The crude mortality rate associated with candidemia was 68.9%. When C. albicans and non- albicans Candida species were compared, in the C. albicans group patients older than 65 years and in the non-albicans Candida species group concurrent bacteremia were found to be statistically higher (p <0.05). Early diagnosis and effective treatment of candidemia have a positive effect on mortality, morbidity and economic losses. Therefore, it is useful to perform candidaemia surveillance for empirical antifungal therapy and necessary infection control measures.

Key Words: Candidemia, Incidence, Candida species, Risk factors, Antifungal susceptibility

DOI: 10.7176/JSTR/5-12-18