Epidemiology and outcomes of candidaemia among adult patients admitted at Hospital Universiti Sains Malaysia (HUSM): A 5-year review
Introduction: Candida organisms are opportunistic fungal pathogens that have become a major cause of nosocomial infections worldwide. We investigated the clinical characteristics and outcomes of hospitalized patients with candidaemia caused by Candida albicans and non-albicans Candida spp at HUSM....
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| Format: | Article |
| Language: | English English English |
| Published: |
International Islamic University Malaysia (IIUM)
2018
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| Online Access: | http://irep.iium.edu.my/64405/ http://irep.iium.edu.my/64405/ http://irep.iium.edu.my/64405/1/64405_Epidemiology%20and%20Outcomes%20of%20Candidaemia%20among_article.pdf http://irep.iium.edu.my/64405/2/64405_Epidemiology%20and%20Outcomes%20of%20Candidaemia%20among_scopus.pdf http://irep.iium.edu.my/64405/13/64405_Epidemiology%20and%20outcomes%20of%20candidaemia%20among_WoS.pdf |
| Summary: | Introduction: Candida organisms are opportunistic fungal pathogens that have become a major cause of
nosocomial infections worldwide. We investigated the clinical characteristics and outcomes of hospitalized
patients with candidaemia caused by Candida albicans and non-albicans Candida spp at HUSM. Materials and
Methods: We retrospectively evaluated all hospitalized patients with candidaemia from January 2010 till
December 2014 based on inpatient hospital records and laboratory data. Results: A total of 134 patients
with candidaemia were enrolled. Candida albicans and non-albicans Candida spp were responsible for 20%
(27/134) and 80% (107/134) of candidaemia cases, respectively. Hospitalized patients with diabetes
mellitus, surgical conditions, or concomitant septicaemia and those who received instrumentations such as
CVC or CBD, and those admitted under medical settings were prone to develop candidaemia caused by
either C. albicans or non-albicans Candida spp. All isolates were susceptible to Fluconazole except for C.
krusei isolates. All-cause mortality within 30 days post diagnosis of candidaemia was 59%. Factors associated
with mortality were solid tumor (p =0.014), surgical illness (p=0.128), central venous catheterization (p=
0.096) and leucocytosis (p=0.116). Only solid tumor was an independent contributory factor for mortality
among patients with C. albicans candidaemia in the multivariate analyses (OR 5.09, 95% CI 1.38,18.74,
p=0.014). Conclusions: The patients’ clinical characteristics were fairly comparable between Candida
albicans and non-albicans candidaemia. The changing epidemiology of candidaemia at this centre was in
fact alarming. The outcome associated with candidaemia was poor. |
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