P261 Candida species in the bloodstream of patients from a tertiary hospital in southern Brazil

Abstract

 Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMCandidemia in hospitalized patients, especially those admitted to intensive care units (ICUs), is responsible for prolonged periods of hospitalization and antifungal therapy, resulting in higher hospital costs and in high mortality rates. The knowledge of the local prevalence of Candida species in the bloodstream and its susceptibility profile is necessary for appropriate therapeutic and surveillance interventions.ObjectivesThis study aims to evaluate the prevalence of candidemia in a tertiary hospital in southern Brazil over a period of around one and a half years, its etiology, and the susceptibility profile of the isolates to antifungal drugs.MethodsA retrospective study was carried out at the University Hospital of Rio Grande (HU-FURG/EBSERH), which has 218 beds. All cases of candidemia, diagnosed by the isolation of yeasts in blood cultures (automated culture system—Bactec®) between January 2021 and April 2022, were included. Databases were analyzed to collect data regarding the total of blood cultures examined in the same period, as well as the etiology and its susceptibility profile to fluconazole (FLU) and amphotericin B desoxicolate (AMB) (microdilution assay according to M27-A3, CLSI).ResultsDuring the sixteen months of the study, 368 patients were examined by blood cultures in our hospital, being 216 from ICUs (n = 101 adult; n = 115 neonatal/pediatric). A total of 21 were diagnosed with candidemia, resulting in a prevalence rate of 5.7%. The majority of the candidemia cases (66.6% - 14/21) occurred in ICUs, including pediatric/neonatal ICU (6/115; 5.2%) and adult ICU (8/101; 7.9%). C. albicans was associated with 52.3% of the cases (n = 11). Among the non-albicans species (n = 10), four were identified through MALDI-TOF (C. parapsilosis: n = 3; C. krusei: n = 1). Antifungal susceptibility showed that 62.5% of the non-albicans isolates tested (6/8) were resistant to FLU or AMB.Conclusions: Candida species are important pathogens associated with sepsis in our hospital, corresponding to around 5% of the bloodstream infections in patients hospitalized, independently of their unit of origin. These data raise awareness of the need for early diagnosis, surveillance of resistance and prevention of this bloodstream infection to optimize the treatment, and promote a better prognosis for critical patients.