Abstract
Candida spp. frequently cause hospital-acquired bloodstream infections (BSI) with a high mortality rate (up to 70%). We analyzed the frequency, infection characteristics, potential predisposing factors, susceptibility to antifungal drugs, biofilm production and other virulence characteristics of Candida spp. isolates obtained from a tertiary care hospital in Niš, Serbia, during a one year period. Medical histories, characteristics of isolated strains and drug susceptibility, as well as the effect on the function of isolated macrophages and other virulence features were evaluated. The obtained results were subjected to student's t-test and multivariate statistical analyzes. Herein we report an annual incidence of 3.65 cases of C. albicans, C. lusitaniae and C. lipolytica infections per 105 population. Out of eight isolated strains, two (25%) were shown to be strong biofilm producers, one (12.5%) caused hemolysis on blood agar and in two (25%) cases macrophages were able to completely eliminate the yeast colonies. Chronic kidney disease, diabetes, malignant and other diseases were present in 37.5, 62.5, 50 and 75%, respectively, in the study group. All patients with Candida BSI received antifungal therapy (amphotericin B), however, hospital mortality was observed in 25% of patients. Evaluation of local Candida epidemiology, antifungal susceptibility and virulence factors, as well as personalized patient risk factors are important for the surveillance of Candida BSI, especially in intensive care unit patients and may contribute to the improved options and outcome for patients with Candida BSI.
Highlights
Introduction: Candida spp. frequently cause hospital-acquired bloodstream infections (BSI) with a high mortality rate
Results: we report an annual incidence of 3.65 cases of C. albicans, C. lusitaniae and C. lipolytica infections per 105 population
Evaluation of local Candida epidemiology, antifungal susceptibility and virulence factors, as well as personalized patient risk factors are important for the surveillance of Candida BSI, especially in intensive care unit patients and may contribute to the improved options and outcome for patients with Candida BSI
Summary
Candida spp. frequently cause hospital-acquired bloodstream infections (BSI) with a high mortality rate (up to 70%). Infection characteristics, potential predisposing factors, susceptibility to antifungal drugs, biofilm production and other virulence characteristics of Candida spp. isolates obtained from a tertiary care hospital in Niš, Serbia, during a one year period. Prevalence of Candida caused fungemia is 8-15% of all hospital-acquired bloodstream infections (BSI) (4th place), making them one of the groups of most common infections in hospitalized patients. In Taiwan, CBSI are the second most common cause of hospitalacquired sepsis (after bacteremia by Staphylococcus species) [4] In this region fungemia causes a very high rate (up to 70%) of mortality and a rise in price of treatment due to prolonged hospitalization and application of antifungal therapy. Well-known risk factors include hematological and endocrine diseases, acquired and congenital immunodeficiency, use of broad-spectrum antibiotics and immunosuppressant drugs (steroids), Stojanović et al – Candida bloodstream infections in Serbian patients
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