Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China

Abstract

BackgroundAlthough the majority of Candida infections occur in the developing world, candidemia epidemiology is poorly understood in these countries. The aim of this study was to investigate the epidemiology of non-Candida albicans (non-C. albicans) candidemia among neonates at Liuzhou Maternity and Child Healthcare Hospital in China.MethodsA retrospective review of all positive blood culture about Candida species in neonatal intensive care unit was conducted between January 2012 and November 2015. Information about demographics, risk factors and outcome of candidemia were collected. Univariate and multivariate logistic regression models were used to identify the risk factors associated with the development of non-C.albicans candidemia.ResultsThe prevalence of candidemia in infants was 1.4%. Non-C.albicans was responsible for 56.5% of neonatal candidemia. The predisposing factors for development of non-C.albicans candidemia among infants included mechanical ventilation [odds ratio (OR), 95% confidence interval (95%CI) = 3.13, 1.07–9.14; P = 0.037] and use of assisted reproductive technology (OR, 95%CI = 4.52, 1.39–14.77; P = 0.012). The overall mortality rate of candidemia was 8.7% and non-C.albicans attributed to 83.3% of all mortalities.Conclusions Non-C.albicans species are the major cause of candidemia in local neonatal group. The study highlights the urgent needs to evaluate the possibility of development of non-C.albicans candidemia in neonates exposed to these risk factors and much emphasis must be laid on the early implementation of medical intervention to reduce the incidences of candidemia in neonates.

Candida bloodstream infections in Serbia: First multicentre report of a national prospective observational survey in intensive care units

“…Finally, few of NAC species, other than C. parapsilosis , occur in this study (~11%) and they were represented by 2 C. tropicalis, and 1 C. glabrata , C. lipolytica and C. lustaniae which were even more rarely identified among the adult (~8%) than among the neonatal/paediatric (~18%) ones. C. tropicalis , is usually seen among patients with leukaemia or neutropenia . It was found here twice, among the paediatric patients ≥1 year old, and in patients with malignancy ≥81 years old (Table ).…”

“…Separate studies in neonatal settings showed increasing trend of C. parapsilosis and other NAC species . C. albicans (~66%) was the predominant species in Greece earlier (1994‐1998), whereas, NAC, particularly, C. parapsilosis (37%) prevailed later (1999‐2000); C. albicans (47%) and C. parapsilosis (44%) has a similar trend in Italy (2000‐2014); and C. albicans (~44%), C. tropicalis (~33%) and C. glabrata (~20%) in Western China (2012‐2015) . A very high prevalence of C. parapsilosis observed in this study in the adults ICU (~46%) and it is in accordance with other reports from the Mediterranean area, however, it is the highest reported value so far.…”

Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

“…An Australian study observed a 1.7‐fold increase in C. glabrata candidemia since 2004 . Additionally, a rise in C. glabrata was reported in Turkey and China . In Brazil, Moretti et al observed an increase in C. glabrata candidemia from 2006 to 2010.…”

“…Candida glabrata is an important agent of candidemia in the USA, and Cleveland et al reported prevalences of 36% for C. albicans , 27% for C. glabrata , 15% for C. parapsilosis and 9% for C. tropicalis . The recent rise in C. glabrata candidemia has been attributed to fluconazole prophylaxis, once this species present intrinsic less susceptibility to this antifungal agent . A study conducted in Argentina, Brazil, Chile, Colombia, Ecuador, Honduras and Venezuela reported that Brazil showed the highest prevalence of C. glabrata candidemia .…”

“…Candidemia due to Candida parapsilosis and Candida tropicalis is more frequent than candidemia caused by C. albicans in some hospitals . Some species, such as Candida glabrata and Candida krusei , are less susceptible to some antifungals, and their increase was already related to the widespread use of antifungal drugs . Species prevalence has also been linked to geographical region, hospital section and patient profile, emphasising the need for local studies …”