Title of article :
Clinical, epidemiological, and mycological features of patients with candidemia: Experience in two tertiary referral centers in Iran
Author/Authors :
Kord ، Mohammad Department of Medical Parasitology and Mycology - School of Public Health - Tehran University of Medical Sciences , Salehi ، Mohammadreza Department of infectious diseases and Tropical Medicine - Research center for antibiotic stewardship and antimicrobial resistance, Imam Khomeini Hospital Complex - Tehran University of Medical Sciences , Hashemi ، Jamal Department of Medical Parasitology and Mycology - School of Public Health - Tehran University of Medical Sciences , Abdollahi ، Alireza Department of Pathology - Imam Khomeini Hospital Complex - Tehran University of Medical Sciences , Alijani ، Neda Department of Infectious Diseases - Shariati Hospital - Tehran University of Medical Sciences , Maleki ، Ayda Department of Medical Parasitology and Mycology - School of Public Health - Tehran University of Medical Sciences , Mahmoudi ، Shahram Department of Parasitology and Mycology - School of Medicine - Iran University of Medical Sciences , Ahmadikia ، Kazem Department of Medical Parasitology and Mycology - School of Public Health - Tehran University of Medical Sciences , Parsameher ، Nasrin Clinical Laboratory - Shariati Hospital - Tehran University of Medical Sciences , Moradi ، Masoud Department of Biostatistics and Epidemiology - Faculty of Health - Mazandaran University of Medical Sciences , Abdorahimi ، Mahsa Department of Microbiology - Islamic Azad University, Shahr-e-Qods Branch , Rezaie ، Sara Department of Chemistry and Biology - Ryerson University , Hashemi Fesharaki ، Shirin Sadat Department of Molecular Pathology - Tehran Heart Center - Tehran University of Medical Sciences , Abbasi ، Kiana Department of Microbiology - Islamic Azad University, Zanjan Branch , Alcazar-Fuoli ، Laura Mycology Reference Laboratory - National Centre for Microbiology - Instituto de Salud Carlos III , Khodavaisy ، Sadegh Department of Medical Parasitology and Mycology - School of Public Health - Tehran University of Medical Sciences
Abstract :
Background and Purpose: Candidemia is a major cause of morbidity and mortality among patients receiving immunosuppressive therapy and those hospitalized with serious underlying diseases. Here, we investigated the epidemiological, clinical, and mycological features of candidemia in Tehran, Iran. Materials and Methods: A prospective observational study of all patients diagnosed with candidemia was performed at two referral teaching hospitals in Tehran, Iran, from February to December 2018. Demographic characteristics, underlying diseases, risk factors, clinical symptoms, and laboratory analyses of candidemic patients with positive culture were mined. Candida isolates were molecularly identified by sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). The antifungal susceptibility testing for fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, caspofungin, micafungin, and anidulafungin against the isolates was performed using CLSI broth microdilution reference method (M27-A3). Results: A total of 89 episodes were identified, with an incidence of 2.1 episodes/1000 admissions. The common underling disease were malignancy (46%), renal failure/dialysis (44%), and hypertension (40%). The overall crude mortality was 47%. C. albicans (44%) was the most frequent causative agent, followed by C. glabrata (21%), C. parapsilosis complex (15%), C. tropicalis (11%), and C. lusitaniae (3.5%). All the isolates were susceptible to amphotericin B. The activity of all four azoles was low against non-albicans Candida species, especially C. tropicalis. Conclusion: The increase in non-albicans Candida species with reduced susceptibility to antifungal drugs might be alarming in high-risk patients. Therefore, accurate knowledge of predisposing factors and epidemiological patterns in candidemia are effective steps for managing and decreasing the mortality rate in candidemia.
Keywords :
Antifungal susceptibility , Candidemia , Epidemiology , Iran , Risk factors
Journal title :
Current Medical Mycology
Journal title :
Current Medical Mycology
