NON-ALBICANS SPECIES: MAIN ACTORS OF CANDIDEMIA? SEVEN-YEAR EXPERIENCE FROM A SINGLE CENTRE

Abstract

Objective: Candidemia is a major cause of mortality among healthcare-associated infections. Considering the increase in non-albicans species in recent years, it is important to define the treatment approach by identifying Candida at the species level. The aim of this study was to evaluate the epidemiological characteristics, risk factors and mortality of patients with candidemia in our hospital. Material and Method: Forty-four patients with Candida species isolated from at least one bottle of blood culture taken during hospitalization between January 2013 and October 2019 were included in the study. Patients’ demographic information, comorbidities, duration of hospitalization and ward, neutropenia, total parenteral nutrition (TPN), steroid administration and invasive device use, antimicrobial treatments used in the last month, source of candidemia, acute phase indicators, Candida species and antifungal resistance, antifungal treatment, clinical response and mortality were evaluated retrospectively. Candida species and antifungal susceptibilities were identified using the automated system VITEK®2 (bioMérieux, Marcy l’Etoile, France). Results: A total of 44 patients with candidemia participated; the median age was 57, and 27 (61.3%) were male. The median length of stay was 33.5 days. Forty-two (95.4%) of the cases were accompanied by multiple comorbidities, and the most common aetiology was malignancy (59%). Most (97.7%) of the patients had received broad-spectrum antibiotic treatment in the last month. Central venous catheters (CVCs) were used in 35 (79.5%) of the cases and 50% of them were treated with TPN. Candida albicans (54.6%) was the most common species, followed by Candida tropicalis (18.2%). Non-albicans species were observed to increase over time. Thirty-day mortality was 36.3%.Conclusion: Non-albicans candidemia was found to have increased over the years in our study. The main risk factors for candidemia were determined as the presence of comorbidities, especially malignancy, prior broad-spectrum antibiotherapy use, TPN treatment and the presence of CVC. The mortality rate in this study was also consistent with the literature.