Candida bloodstream infections in a Greek tertiary hospital: 5-year survey – epidemiology and in vitro antifungal susceptibility profiles

Eleni Kraniotaki, Efstathia Perivolioti, Martha Nepka, Maria Mpournia, Evangelia Douka, Vassilis Papastamopoulos, Athanassios Skoutelis, Kimon Fountoulis

Abstract: 

Background: During the last decades the rates of invasive Candida infections have increased dramatically. As Candida infections are associated with significant morbidity and mortality, monitoring of Candida species distribution among significant isolates and their antifungal resistance is required. A retrospective study was conducted between January 2010 and November 2015 at Evaggelismos General Hospital. The incidence of Candida species causing bloodstream infections and their susceptibility profile were evaluated. The purpose of this study was to define the rate of Candida isolates among all positive blood cultures, species distribution between C. albicans and C. nonalbicans, and antifungal susceptibility test among them.

Material/methods: Records from the microbiology department were evaluated for the study period. All hospitalized patients who had ≥1 blood culture positive Candida were included in the study. Automated blood culture systems (BACTEC 9240, BD) were used. All isolates were speciated by the Vitek 2 system (Biomerieux, France). Susceptibility testing to amphotericin B, fluconazole, voriconazole, flucytocine, micafungin and caspofungin was performed by the Vitek 2 system and to anidulafungin by the E test (AB Biodisk, Sweden). Result interpretation was according to the CLSI guidelines (revised M27-S4).

Results: A total number of 7588 positive blood cultures were reviewed. Fungi were cultured from 521 positive blood cultures (6.9%). Candida species were found to be the fourth most common organism causing blood stream infections (BSIs). Overall, Candida accounted for 6.9% of all BSIs - being responsible for 7.8% of BSIs in the intensive care unit and 5.7% of infections in non-ICU patients. C. albicans represented the most common isolate in non-ICU wards. C. parapsilosis represented the 50% of isolates in ICU. All Candida albicans isolates were susceptible to azoles and candines. Available results are given in Table 1.

Conclusions: Candidemia is a significant problem especially in medical wards. Early recognition and prompt empirical treatment are essential to improve outcomes of patients at risk for developing candidemia. Improvement of surveillance is crucial to recognizing emergence of highly resistant strains.

Tables: 

2016

Poster: 

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abstract No: 

#4076

Full conference title: 

26th European Congress of Clinical Microbiology and Infectious Diseases
    • ECCMID 26th (2016)