Epidemiology, species distribution, clinical characteristics and mortality of candidaemia in a tertiary care university hospital in Turkey, 2007‐2014

Abstract

Candidaemia still continues to be a serious medical concern and the epidemiology of candidaemia varies according to geographical areas. We aim to determine the incidence, local epidemiology, Candida species distribution and crude mortality rates of candidaemia. We retrospectively evaluated candidaemia episodes in between January 2007 and August 2014. We compared demographic, clinical, microbiological findings and mortality rates of episodes caused by Candida albicans and non-albicans Candida species. Overall the candidaemia incidences were 1.23 episodes/1000 admissions. A significant negative slope among candidaemia episodes and years was determined. Overall C. albicans (54.6%) was the most common species followed by Candida glabrata, Candida tropicalis and Candida parapsilosis respectively. Preinfection hospital stay and length of hospital stay were statistically longer in patients with non-albicans Candida candidaemia than in patients with C. albicans candidaemia. The source of candidaemia was unknown in 52.5% of all episodes. Central venous catheters among non-albicans Candida candidaemia episodes and urinary system among C. albicans candidaemia episodes were common source of candidaemia compared to each other. Previous antifungal therapy preceding candidaemia and concomitant bacteraemia were significantly associated with non-albicans Candida candidaemia. Continuous local surveillance will preserve its pivotal importance in formulating empirical antifungal therapy and improving management of candidaemia.

Morbidity and mortality of candidaemia in Europe: an epidemiologic meta-analysis

“…In total, we included 107 studies in our analysis. [13][14][15][16][18][19][20][21][22]25,26,34,36,37, Fifty [13][14][15][16]22,37,52,[114][115][116]120,121,126,128,129,133,136 of 107 studies [13][14][15][16][18][19][20][21][22]25,26,34,36,37, were teaching hospital-based, 18 were populationbased, [20][21][22]25,26,34,…”

“…73 In studies only reporting teaching hospital data, the pooled IR of candidaemia was 0.96 per 1,000 admissions per year (95% CI 0.79-1.12) ( Figure 3) [13][14][15][16]22,52,[55][56][57][58][59][60][61][62][63]66,71,[73][74][75]77,79,81,[83][84][85]114,115,120,136 . Pooled analysis indicated that studies with a study median between 2001 and 2010 had a higher IR with 1.11 (95% CI 0.83-1.39) [13][14][15][16]55,60,61,63,66,71,[73][74][75]81,136 compared to studies with a study median between 1990 and 2000 with 0.62 (95% CI 0.41-0.83), 22,…”

“…Pooled analysis indicated that studies with a study median between 2001 and 2010 had a higher IR with 1.11 (95% CI 0.83-1.39) [13][14][15][16]55,60,61,63,66,71,[73][74][75]81,136 compared to studies with a study median between 1990 and 2000 with 0.62 (95% CI 0.41-0.83), 22,77,79,[82][83][84][85] and studies with a study median between 2011 and now with 0.97 (95% CI 0.56-1.39) ( Figure 3) (p-value for interaction <0.001). 52,[56][57][58][59]62,114,115,120 Studies from southern European countries had a higher pooled IR (1.13, 95% CI 0.9-1.35) 13,14,16,52,[56][57][58][60][61][62][63]66,71,[73][74]…”

Prevalence, virulence factors and antifungal susceptibility of Candida spp. 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.…”

Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections

“…Accurate identification of Candida species from invasive candidiasis/BSIs is important in order to initiate appropriate and timely antifungal treatment. Also, antifungal susceptibility testing using a reference method is essential to facilitate accurate treatment of these life‐threatening infections . In this study, we report the profile of Candida isolates from cases of candidaemia at a tertiary care hospital and emphasise that many of the C. auris cases and other rare yeast species from BSIs may go unidentified if appropriate methods are not used for identification.…”