Evaluation of candidemia devolping in the intensive care units at Gaziantep University Medical School

Candidemia is important because of its high mortality, morbidity and increased care costs, in addition to being a difficult to diagnose and treat bloodstream infection. Identification of Candida species in blood cultures and detection of antifungal susceptibility are important for effective treatment. In this study, it was aimed to determine the frequency and the risk factors of candidemia, the distribution of species, the susceptibility patterns to antifungal drugs, and to investigate the mortality of candidemia and the risk factors associated with mortality in the ICUs of our hospital. The study included 53 patients who were followed up with the diagnosis of candidemia in Gaziantep University Faculty of Medicine ICUs between January 1, 2020 and March 1, 2021. The incidence of candidemia in the 14-month study period was 10.57 (1,05%) in 1000 admissions. C. albicans (47,2%) was most frequently isolated, C. tropicalis (22,6%), C. glabrata (18,9%) and C. lusitaniae (3,8%) were most commonly isolated among non-albicans species. Although no antifungal resistance was detected in C. albicans; AMB (14,8%), caspofungin (7,4%), micafungin (7,4%), flucytosine (3,7%), -except C.glabrata- fluconazole and voriconazole (11,7%) resistance were found in non-albicans species. Compared to the control group, hemodialysis, long hospital stay, use of TPN, candiduria and mortality rate were statistically significantly higher in candidemia group. COVID-19 infection accompanying candidemia was detected at a rate of 15,1%, and it was found statistically significantly more with non-albicans species than C. albicans. Concurrent bacteremia was detected in 50,2% of candidemia cases. Accompanying Gram (+) bacteremia was 50,9% and Gram (-) bacteremia was 16,9%. The crude death rate attributed to candidemia was 83%. Elderly and thrombocytopenia were associated with mortality. In conclusion, identification of candidemia causing candida species and determination of antifungal susceptibility are crucial in terms of choosing the right antifungal agent for the effective treatment of these life treating infections. Changes in the rates of antifungal resistance and species distribution of causative microorganisms should be carefully examined and the causes of those changes should be extensively investigated. Epidemiological data for candidemia of each hospital's should be fully up-to-date and appropriate treatment selection should be made according to patient characteristics and risk factors. Key words: Candidemia, Risk factors, Antifungal sensitivity, İnvasive candidiazis, Mortality