Candida glabrata candidemia: An emerging threat in critically ill patients

Area of Science:

• Medical Mycology
• Infectious Diseases
• Critical Care Medicine

Background:

• Candidemia is a common nosocomial bloodstream infection in critically ill patients.
• Candida glabrata is an emerging cause of candidemia, particularly in Intensive Care Unit (ICU) settings.
• Limited data exists on the specific impact and risk factors of Candida glabrata candidemia in ICU patients.

Purpose of the Study:

• To investigate the epidemiology and clinical features of Candida glabrata candidemia in ICU patients.
• To identify mortality-related risk factors for Candida glabrata candidemia in this population.
• To evaluate the outcomes of patients with Candida glabrata candidemia.

Main Methods:

• Retrospective review of medical records of ICU patients from 2006 to 2010.
• Analysis of epidemiological data, clinical characteristics, and risk factors for mortality.
• Comparison of outcomes based on antifungal treatment (fluconazole vs. amphotericin B).

Main Results:

• Candida glabrata accounted for 18.05% of candidemia cases (26/144), being the third most common species.
• The incidence was 0.21 per 1000 ICU admissions.
• Common risk factors included broad-spectrum antibiotics, central venous catheter, mechanical ventilation, diabetes mellitus, and age >65 years. Urine was the most common source (23%).
• The 30-day mortality rate was high at 53.8%.
• Fluconazole treatment was associated with better outcomes than amphotericin B.
• Renal failure requiring hemodialysis was significantly associated with mortality.

Conclusions:

• Candida glabrata is a significant cause of candidemia in ICUs, with a high mortality rate (53.8%).
• Renal failure requiring hemodialysis is a key risk factor for mortality.
• Further research is needed to identify additional mortality risk factors for Candida glabrata candidemia.