感染症と治療ジャーナル

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Epidemiology of Nosocomial Candida Species, Resistance Patterns, and the Associated Crude Mortality

Jamal Wadi Al Ramahi, Ala’a Bader Pharm, Nemah Bashir, Asma Bazara, Dalia Shami and Mahmoud J Numan

Background: To study the nosocomial Candida epidemiology, susceptibility patterns, and associated cude mortality.

Methods: A multicenter prospective study. Laboratory logbooks were reviewed. Candida species considered were isolates or invasive. Patients' records were queried for the characteristics and demography. Statistical analysis was by Fisher's Exact Test for categorical and continuous variables, mean and ANOVA where appropriate.

Results: 307 Candida species were collected; total 15.2% and 2.48% were invasive infections percent admission. The mean length of hospital stay was 19 days (95% CI, 15.87 – 22.18, trimmed mean 15.18 days). C. albicans accounted for 34.5% and Non-albicans Candida 65.5% (p=0.000). No difference between C. albicans and Non-albicans candida in gender (p =0.148), age (p=0.305) and comorbidities (p=0.194), neither was the type of surgery (p=0.166) nor white blood cell count (p=0.595) 79 patients died; 31 in C. albicans and 48 in the non-albicans Candida (p=0.337). C. albicans susceptibility to fluconazole was 94.5%, C. glabrata 68.8%. Voriconazole was 100% active for all Candida species. C. albicans was 100% susceptible to echinocandins; C. glabrata 97.8%. Candida species were 93% susceptible to Amphotericin-B. The invasive candidiasis-associated crude mortality was 50%.

Conclusion: Non-albicans Candida was more prevalent than C. albicans. The antifungal resistance rates were high, and the crude mortality rates were similar for Candida species. No single case of C. auris was documented or suspected.