Candidemia cases observed between 2014-2016 in a research hospital in Turkey

Abstract

Background: Candidemia causes longer stay, higher costs and mortality in intensive care unit(ICU). C.albicans is the most prevalent isolate, but non-albicans isolates are rising. Systemic antifungal therapy should be initiated immediately in all cases. Methods & Materials: We reported nosocomial candidemia cases in years 2014-2016 in ICU retrospectively. Results: A total of 39 cases were recorded. Demographic characteristics were reported (Table 1). Twenty eight patients was septic. Most frequent sepsis source was respiratory system. Most frequent isolate was C.albicans. All patients had systemic antifungal therapy. Mean duration of therapy was 13.4 days. Most common used antifungals were echinocandins. Fourteen patients had previous candida colonization. Mean period between candida growth and antfungal treatment was 1.9 days. Mortality rate was 66.6%.Table 1Dead n = 26(66.6)Lived n = 13(33.3)Total n = 39(100)Age(Mean ± SD)(min-max)69.88 ± 9.85(52-93)55.07 ± 18.51(24-81)65.89 ± 19.5519(18-95)GenderMale n(%)16(64)9(36)25(100)Cause of admission(n)Medical18523Surgical448Trauma459ICUs (n)Neurosurgical347Medical617Surgical426Pulmonology314Neurological314Reanimation-anaesthesiology7411Comorbidity(n)Diabetes11516COPD415Congestive heart failure415Chronic renal failure628Renal replacement therapy415Neutropenia202Steroid use606Malignancy729Surgical procedure (n)71017Operation area (n)Abdominal7815Others-22Sepsis/Septic shock(n)20828Sepsis Source (n)Respiratory13316Gastrointestinal314Genitourinary213Central catheter213Others-22Candida Species(n)C.albicans16622C.parapsilosis-11C.kefyr-11C.krusei1-1C.sake224Candida spp.7411AntifungalsFluconazole628Amphotericin B112Caspofungin71017Anidulafungin12-12 Open table in a new tab Conclusion: In critically ill patients, most common invasive fungal infection is candidemia. Mortality is high despite antifungal treatment. When choosing empirical antifungal treatment considering local epidemiology of Candida species is important.