Predictors and outcomes of Candida bloodstream infection: eight-year surveillance, western Saudi Arabia

Summary Objectives To assess the epidemiological pattern of Candida bloodstream infection (BSI) over an 8-year period (2002–2009) in King Abdulaziz Medical City, western Saudi Arabia. Method A retrospective chart review was performed. Results A total of 258 BSI were identified in 134 males (53.2%) a...

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Bibliographic Details
Published in:International journal of infectious diseases 2014-04, Vol.21, p.5-9
Main Authors: Al Thaqafi, Abdul Hakeem O, Farahat, Fayssal M, Al Harbi, Maher I, Al Amri, Abdul Fattah W, Perfect, John R
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antifungal Agents - therapeutic use
Candida - pathogenicity
Candida - physiology
Candida albicans - pathogenicity
Candida albicans - physiology
Candidemia
Candidemia - complications
Candidemia - drug therapy
Candidemia - epidemiology
Candidemia - microbiology
Candidiasis - complications
Candidiasis - drug therapy
Candidiasis - epidemiology
Candidiasis - microbiology
Child
Child, Preschool
Drug Resistance, Fungal
Epidemiological Monitoring
Epidemiology
Female
Fluconazole - therapeutic use
Humans
Infant
Infectious Disease
Male
Microbial Sensitivity Tests
Middle Aged
Neoplasms - complications
Neoplasms - drug therapy
Neoplasms - epidemiology
Neoplasms - microbiology
Pulmonary/Respiratory
Retrospective Studies
Risk Factors
Saudi Arabia
Saudi Arabia - epidemiology
Survival Analysis
Treatment Outcome
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Summary:Summary Objectives To assess the epidemiological pattern of Candida bloodstream infection (BSI) over an 8-year period (2002–2009) in King Abdulaziz Medical City, western Saudi Arabia. Method A retrospective chart review was performed. Results A total of 258 BSI were identified in 134 males (53.2%) and 118 females (46.8%). There were 86 (34.1%) cases of Candida albicans and 166 (65.9%) non- albicans Candida species. Malignancy was independently associated with the development of candidemia by non- albicans Candida species (odds ratio 3.24, 95% confidence interval 1.25–8.41). Fluconazole in vitro susceptibility was 38.5% for C. albicans and 52.5% for other Candida species. The overall, crude 12-month mortality rate was 50% for C. albicans and 57.8% for non- albicans Candida species. Conclusions The antifungal resistance coinciding with a change in the epidemiologic pattern of candidemia identified in this study is alarming and urges the need for a review of empiric antifungal therapy and potential contributing environmental factors.
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2013.12.012