The analysis of candidemia cases followed in the Cukurova University Hospital according to their epidemiologic, clinical and antifungal susceptibility characteristics

Aim: The importance of nosocomial blood stream infections caused by Candida species has substantially increased in recent years. Over the past 2 decades, Candida species have become the fourth most frequently isolated pathogens from blood cultures. The aim of this retrospective study was to analyze of the changing characteristics candidemia cases and their etiologies.Material-Method: The candidemia cases between August 2003 and December 2007 were evaluated retrospectively with respect to their epidemiologic, clinical and microbiological manifestations.Results: At the time of diagnosis, 88 patients (75.8%) were hospitalized in an adult intensive care unit and 28 (24.2%) were in medical and surgical wards. Males comprised 57.7% (67) of case patients and 49 patients (42.3%) were female. The median age was 48.4 ±19 years. The most common demonstrated risk factors for candidemia were broad spectrum antibiotic use (99.2%), urinary catheter (88.3%) and central venous catheter (65.0%). Predominant species was C. albicans (38.6%) of 120 candidemia cases; followed by C. parapsilosis (28.3%), C. tropicalis (10.8%) and C.glabrata (5.0%) consecutively. Other Candida species were isolated from 18.3% of cases. Antifungal susceptibility results demonstrated that flucanozole can be used safely. Fluconazole resistance occurred in 2.2% cases of C. albicans and 11.4% of non-albicans Candida. Itraconozole resistance occurred in 7.5% cases of C. albicans and 10.3% of non- albicans Candida. No statistically difference was established between the distributions of species according to the years (p=952). There was no difference between resistance tendencies of species. No isolate was resistant to amphotericin B. Mortality rate was 57.7% (67 cases). No correlation was established between mortality and drug resistance.Conclusion: Our study demonstrated that the proportion of candidemia caused by non- albicans Candida species is increasing substantially between years. Because of the antifungal resistance of these species, causative pathogens were isolated according to their species and antifungal susceptibility tests were performed.