Characteristics and clinical outcomes of patients with Candida bloodstream infections in a tertiary care hospital in Jordan

Abstract

Introduction: Candida species are important causes of bloodstream infections, accounting for significant morbidity and mortality in hospitalized patients. Methodology: A retrospective observational study was conducted in an academic tertiary hospital of Jordan. The medical records of patients hospitalized over a ten-year period. were reviewed and patients with candidemia were identified. Data analysis included the infecting Candida species, resistance to antifungals, and risk factors associated with mortality. Results: A total of 158 cases of candidemia were identified, with an overall incidence rate of 0.48 episodes/1,000 admissions. The proportion of candidemia caused by Candida albicans (44.3%) was higher than that of candidemia caused by non-albicans Candida species (42.4%). Exposure to antibiotic therapy before hospitalization was the only independent factor associated with non-albicans Candida infection (OR 2.454; p = 0.033). The overall crude 30-day mortality was 38.7%. Central venous catheterization (OR 0.255; p = 0.026), mechanical ventilation (OR 0.162; p = 0.003), severe sepsis and septic shock (OR = 0.073; p = 0.008), admission to intensive care unit (OR 0.78; p = 0.001), C. albicans (OR 0.235; p = 0.018), length of stay (OR 1.057; p = 0.001), number of comorbidities (OR 0.580; p = 0.008) were independent risk factors for 30-day mortality. Conclusion: This study identified several risk factors associated with blood stream infections caused by Candida over 10-years period. Continuous surveillance programs to monitor such types of infection are of great value to antimicrobial stewardship programs.

Update on invasive fungal infections in the Middle Eastern and North African region

“…The study evaluating 2011-2012 data of three hospitals, with a mean of 2.2-2.5 co-morbid conditions per patient, has reported the incidence of IC to be 0.39 cases per 1000 hospital discharges [39]. In Jordan, an overall incidence rate of 0.48 episodes/1000 admissions was recorded in an academic tertiary hospital, with a 30-day mortality rate of 38.7% [40]. In Turkey, several studies have shown that nosocomial IC, including candidemia, ranged between 1.2/1000 and 5.6/1000 admissions [41][42][43].…”