Hospital-acquired candidaemia: experience from a developing country

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Hospital Epidemiology

Background:

• Hospital-acquired candidaemia represents a significant challenge in healthcare settings.
• Identifying prevalent risk factors is crucial for effective prevention and management strategies.

Purpose of the Study:

• To review hospital-acquired candidaemia episodes over a two-year period.
• To identify predominant risk factors, common Candida species, and treatment outcomes.
• To compare outcomes between amphotericin B and fluconazole therapies.

Main Methods:

• Retrospective review of 37 episodes of hospital-acquired candidaemia.
• Analysis of patient demographics, risk factors, Candida species, and treatment regimens.
• Assessment of mortality rates and factors influencing patient outcomes.

Main Results:

• Predominant risk factors included antibiotic therapy (100%), central venous catheters (94.6%), and parenteral hyperalimentation (78.3%).
• Candida albicans (56.8%) and Candida tropicalis (13.5%) were the most common isolates.
• Overall mortality was 48.6%, with no significant difference between amphotericin B and fluconazole treatments.

Conclusions:

• Multiple risk factors, particularly antibiotic use and central venous catheters, are strongly associated with hospital-acquired candidaemia.
• Current antifungal treatments showed similar efficacy, and patient age, Candida species, or bacteraemia did not significantly impact outcomes.
• Findings align with those reported in developed countries, suggesting universal challenges in managing invasive candidiasis.