A Retrospective Study of Invasive Candidiasis in a Tertiary Teaching Hospital

Area of Science:

• Medical Mycology
• Infectious Diseases
• Epidemiology

Background:

• Invasive candidiasis is a critical threat in healthcare settings, associated with high mortality rates.
• Evolving etiological spectrum and antifungal resistance complicate treatment strategies for invasive candidiasis.
• Identifying predisposing factors is essential for managing invasive fungal infections.

Purpose of the Study:

• To investigate the epidemiological and microbiological characteristics of invasive candidiasis.
• To analyze species distribution, antifungal resistance, risk factors, and outcomes in a tertiary hospital.
• To understand the changing landscape of invasive candidiasis in hospitalized patients.

Main Methods:

• Retrospective analysis of 86 adult inpatients with invasive candidiasis from April 2019 to March 2022.
• Data collection on species identification, antifungal susceptibility, clinical risk factors, and patient outcomes.
• Evaluation of factors including antibiotic use, intravascular catheters, and comorbidities.

Main Results:

• Non-albicans Candida (NAC) species predominated (77.91%), with *Candida parapsilosis* being the most common NAC.
• *Candida albicans* accounted for 22.09% of cases.
• High prevalence of risk factors including antibiotic use (94.2%), intravascular catheters (75.6%), and diabetes mellitus (47.7%).
• Mortality rate was 27.9%, with multiple comorbidities significantly increasing mortality risk (p=0.016).

Conclusions:

• Invasive candidiasis presents a persistent challenge due to the rise of NAC and antifungal resistance.
• Prompt diagnosis in high-risk individuals, antimicrobial stewardship, and catheter care are vital.
• Enhanced diagnostic tools are needed for timely initiation of antifungal therapy.