Epidemiology of Candida blood stream infections: experience of a tertiary care centre in North India

Abstract

Introduction: Bloodstream infections due to Candida species are becoming a major cause of morbidity and mortality in hospitalized patients. The spectrum of candidemia has changed with the emergence of non-albicans Candida species, especially among critically ill patients. Methodology: In a retrospective study (July 2009 to December 2009) on candidemia, various Candida species isolated from blood cultures were characterized and studied along with the determination of their antifungal susceptibility to amphotericin B, itraconazole, and fluconazole by Etest. Probable risk factors for patients in the intensive care unit (ICU) presenting with candidemia were also analyzed. Results: During the study period, a total of 4651 samples were received, out of which 468 samples (10.06%) were positive for growth of organisms: 441 (94.20%) aerobic bacterial pathogens and 27 (5.79%) Candida species. The most common Candida spp. isolate was C. tropicalis (40.8%) followed by C. albicans (29.6%), C. glabrata (18.5%) and others (11.1%). Out of the 27 Candida strains, 24 (88.9%) were isolated from patients treated in the ICU. Among these, association of previous use of broad-spectrum antibiotics in 22 patients (91.6%) and central line catheter insertion in 20 patients (83.3%) were found to be statistically significant as compared to non-candidemia patients (p <0.05). Antifungal susceptibility testing of the isolates revealed a lower level of drug resistance to amphotericin B (18.5% of the isolates) versus 77.8% resistance to fluconazole. Conclusion: Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious bloodstream fungal infection.

Antifungal susceptibility, risk factors and treatment outcomes of patients with candidemia at a university hospital in Saudi Arabia

“…A previous study done at the same hospital by Akbar and Tahawi [9], found that patients with CVCs (77%) who received broad-spectrum antibacterial therapy (87%) were associated with candidemia. The study of Chander et al [6], has similar results to ours regarding associated risk factors with candidemia.…”

“…The spectrum of candidemia has been changed especially among critically ill patients due to emergence of non-albicans Candida (NAC) species, including C. tropicalis, C. parapsilosis, C. krusei, and C. glabrata. The increasing use of azole agents is suggested to be responsible for this epidemiological shift [5,6].…”

Quercetin Sensitizes Fluconazole-Resistant Candida albicans To Induce Apoptotic Cell Death by Modulating Quorum Sensing

“…There are more than Candida 20 species, the most common of which is Candida albicans. Candidiasis is the fourth most common cause of health care-associated bloodstream infections in India and the United States (1). This yeast normally lives on the skin and mucous membranes without causing infection.…”

Pattern of susceptibility to azoles by E test method in candidemia patients

“…In previous studies Candida parapsilosis was next to Candida, 10,13 whereas in few Indian studies Candida tropicalis was the most common species isolated followed by Candida albicans. 14,15 The distribution of the species is different in various regions and studies. Our data also suggested that non-albicans Candida (61%) was the predominant species when compared to Candida albicans (39%), which establishes the importance of non-albicans Candida in causing blood stream infections.…”