Candidemia Among ICU Patients: Species Characterisation, Resistance Pattern and Association With Candida Score: A...

Area of Science:

• Medical Mycology
• Infectious Diseases
• Intensive Care Medicine

Background:

• Candidiasis is a major cause of illness and death in immunocompromised patients in intensive care units (ICUs).
• Accurate identification of Candida species is crucial for guiding effective antifungal therapy.
• Current guidelines lack clarity on initiating treatment when fungemia is not definitively proven.

Purpose of the Study:

• To evaluate Candida species identification and antifungal susceptibility in ICU patients.
• To correlate patient risk factors and comorbidities with Candida colonization and infection.
• To assess the utility of the Candida score in predicting invasive candidiasis.

Main Methods:

• Prospective collection of diverse clinical samples (urine, sputum, blood, etc.) from ICU patients over 16 months.
• Standard laboratory procedures including microscopy, culture, and antifungal susceptibility testing.
• Correlation of demographic data, risk factors, and Candida scores with laboratory findings.

Main Results:

• 125 positive cultures from 120 patients were analyzed; diabetes mellitus was the most common comorbidity.
• Total parenteral nutrition was the most frequent risk factor identified.
• Non-albicans Candida, particularly C. tropicalis, predominated. Voriconazole (80%), fluconazole (67.78%), and amphotericin B (62.22%) showed significant susceptibility.

Conclusions:

• Fluconazole is an effective antifungal agent for Candida infections, available in oral and parenteral forms.
• Voriconazole should be reserved for cases unresponsive to initial fluconazole therapy.
• Increasing antifungal resistance in Candida species, especially Candida albicans, is a significant clinical concern.