Epidemiological profile of candida isolated from septicemic patients

Abstract

Introduction: Candida is an important cause of blood stream infections (BSI). It ranks fourth in the United States and seventh in Europe. It is a leading cause of morbidity and mortality in critically ill patients. There is an epidemiological shift from a predominance of Candida albicans to non albicans Candida species in recent decades. Speciation of Candida can help in better approach towards outcome of the patients and to know the intrinsic resistance of various Candida species to antifungal agents. Objectives: To determine the epidemiological profile of Candida infection in septicemic patients and to identify the Candida species isolated. Materials and Methods: A hospital based descriptive study was conducted over a period of 2 years in a tertiary care centre. Candida was isolated in blood culture from 54 patients. Candida isolates were identified to the species level, using both conventional and automated techniques. Results: The most common Candida species isolated were C.parapsilosis complex, C.tropicalis, C.albicans, C.krusei, C.glabrata, C.haemulonii, C.firmetaria and C.guillermondii var membranifaciens. Significant risk factors for candidemia includes HIV/AIDS, diabetes, antibiotic therapy, chemotherapy, presence of intravascular catheters, malignancy, surgery, parenteral nutrition. 51.85% of the patients received antifungal therapy with Fluconazole (71.43%) being the most common treatment option which is followed by Voriconazole (10.71%) and Amphotericin B (7.14%). Conclusion: Candidemia is a significant cause of mortality with C. parapsilosis and C. tropicalis being the predominant pathogens. This study shows a significant epidemiological shift to higher isolation of non albicans Candida species. Keywords: Candida species, Epidemiological profile, Septicemic, Risk factors.