Candidaemia in Malaysia: Surprising Results from a National Study

Ref ID: 18752

Author:

Q. A. Nguyen, BMedSc MHA MHIM – Program Coordinator1,2, D. J. E. Marriott, MBBS, BScMed, FRACP, FRCPA – Senior Staff Specialist 1, Malaysian Candidaemia Study (MaCaS) Group;

Author address:

1St Vincent’s Hosp. Sydney, Sydney, Australia, 2Garvan Inst. of Med. Res., Sydney, Australia.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Candidaemia in Malaysia has never been investigated on a national scale. We report the preliminary results from the multicentre Malaysian Candidaemia Study (MaCas). Methods: A one-year study was undertaken to collect clinical and isolate data from ten hospitals across Malaysia to determine the incidence, prevalence and epidemiology of candidaemia. All Candida spp. isolated from positive blood cultures were included with species identification undertaken using standard procedures. Risk factors, demographics, treatment, susceptibility results and outcomes were described. Results: In the first nine months, 131 episodes of candidaemia (14.5 episodes per month) were identified. The mean age was 55.7 years with 55.0% being male. Candidaemia occurred a mean of 16.1 days into the hospital admission. The mean length of stay was ten times the national average (33.2 vs 3.2 days). The medical unit was the main admitting service (51.9%); unusually only six haematology patients were identified. 49.6% of patients were admitted to Intensive Care Units (ICU) and 23.1% to High Dependency Units (HDU). Following diagnosis 68.7% received antifungal therapy. The timeliness of results and the death of the patient were the principle reasons for no treatment. Overall mortality was 47.3%. ICU admission, haemodialysis and non-receipt of antifungal therapy were contributing factors to death (p < 0.05). The distribution of Candida spp. differs remarkably from other national studies, with C tropicalis (29.8%) equalling C albicans (29.0%). C parapsilosis (18.3%) and C glabrata (9.9%) were third and fourth respectively. The higher rate of non-albicans (71.0%) could not be attributed to prior antifungal use (p = NS). Conclusions: The clinical profile of candidaemia in Malaysia is very similar to other countries in terms of risk factors, outcomes and mortality. However a striking difference is the Candida spp. distribution. This poses a challenge as not all hospitals routinely undertake species identification or susceptibility testing and this may influence patient outcomes. The study continues.

Abstract Number: K-947

Conference Poster: y

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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