Mortality and risk factor analysis for Candida blood stream infection: A three-year retrospective study

Müderris, Tuba; Kaya, Selçuk; Örmen, Bahar; Gökmen, Ayşegül Aksoy; Akpınar, Ceren Varer; Gül, Selden

doi:10.1016/j.mycmed.2020.101008

Cited by 18 publications

(14 citation statements)

References 30 publications

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“…According to the studies conducted in Turkey, the most frequent species were C. albicans, C. parapsilosis, C. tropicalis, and C. glabrata (7, 11, 27, 29, 30), which is in line with other studies in the literature (6, 16,17,21,22,24,26). Candidaparapsilosis was reportedly the most frequent species in some studies (27,31,32), whereas C. glabrata was the leading species in the studies of Israel et al (19) and Aldardeer et al (33). The prevalence of isolated Candida spp.…”

Section: Discussionsupporting

confidence: 83%

Changing Trends of Candida Species and Antifungal Susceptibility Profile of Candida Bloodstream Isolates: A 5-Year Retrospective Survey

Yardimci

Arman

2022

Jundishapur J Microbiol

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Background: Candida species have emerged as one of the most common causes of bloodstream infections (BSIs). There are limited data on the distribution of Candida spp. and susceptibility by year. Objectives: In this study, we analyzed changes in the distribution of Candida spp. and their antifungal susceptibility profiles from blood cultures. Methods: Records from January 2016 to December 2020 were obtained from the microbiology laboratory in Istanbul. Antifungal susceptibility tests were performed using the VITEK 2 compact system and evaluated according to EUCAST breakpoints. A total of 241 unique candidemia episodes were included in this study. Results: Candida albicans was the predominant pathogen (n = 95, 39.42%), followed by C. parapsilosis (n = 82, 34.02%), C. glabrata (n = 18, 7.47%), C. tropicalis (n = 17, 7.05%), C. krusei (n = 15, 6.22%), and other Candida spp. (n = 14, 5.79%). There was no statistically significant difference in the percentage of episodes of Candida spp. After data analysis, a tendency to shift from C. albicans to C. parapsilosis was observed in the period analyzed in this study. Candida albicans was the most common species in intensive care units (ICUs), hematology and hemopoietic stem cell transplantation units, and surgical clinics, with C. parapsilosis predominant in medical clinics. In general, micafungin susceptibility was the highest, and fluconazole was the lowest. There was reduced sensitivity to fluconazole and voriconazole for C. albicans and C. parapsilosis over 5 years. Conclusions: Detecting changes in the distribution of Candida spp. and antifungal susceptibility over time will lead to the selection of appropriate empirical therapy and monitor phenomena of antifungal resistance. Empirical treatment with antifungal agents is associated with high costs, toxicities, and risk of antifungal resistance. Therefore, it is mandatory to determine and monitor Candida spp. and antifungal susceptibility testing to select appropriate antifungal agents.

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Section: Discussionsupporting

confidence: 83%

Changing Trends of Candida Species and Antifungal Susceptibility Profile of Candida Bloodstream Isolates: A 5-Year Retrospective Survey

Yardimci

Arman

2022

Jundishapur J Microbiol

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“…The role of concurrent bacterial infections on in-hospital mortality in patients with candidemia has been established in previous reports [ 12 , 45 ], similar to our results. It was anticipated that concomitant bacterial infections would lead to candidemic patients being vulnerable to severe sepsis or septic shock and eventually increase the risk of mortality; therefore, effective antimicrobial agents against concurrent bacterial infections should be initiated aggressively to improve the clinical prognosis.…”

Section: Discussionsupporting

confidence: 92%

Impact of Nutritional Assessment on the Clinical Outcomes of Patients with Non-albicans Candidemia: A Multicenter Study

et al. 2021

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Several studies have demonstrated that malnutrition is a negative prognostic factor for clinical outcomes. However, there is limited evidence for the effect of malnutrition on clinical outcomes in patients with candidemia. We investigated the relationship between malnutrition and all-cause 28-day mortality among patients with non-albicans candidemia. Between July 2011 and June 2014, all adult patients with non-albicans candidemia, including C. tropicalis, C. glabrata, C. parapsilosis and so on, were enrolled. The Malnutrition Universal Screening Tool (MUST) scores were used to determine the patients’ nutritional status before the onset of candidemia. A total of 378 patients were enrolled; 43.4% developed septic shock and 57.1% had a high risk of malnutrition (MUST ≥ 2). The all-cause 28-day mortality rate was 40.7%. The Cox proportional hazards model revealed that C. tropicalis (HR, 2.01; 95% CI, 1.24–3.26; p = 0.005), Charlson comorbidity index (HR, 1.10; 95% CI, 1.03–1.18; p = 0.007), Foley catheter use (HR, 1.68; 95% CI, 1.21–1.35; p = 0.002), concomitant bacterial infections (HR, 1.55; 95% CI, 1.11–2.17; p = 0.010), low platelet count (HR, 3.81; 95% CI, 2.45–5.91; p < 0.001), not receiving antifungals initially (HR, 4.73; 95% CI, 3.07–7.29; p < 0.001), and MUST ≥ 2 (HR, 1.54; 95% CI, 1.09–2.17; p = 0.014) were independently associated with all-cause 28-day mortality. A simple screening tool for nutritional assessment should be used for patients with non-albicans candidemia to detect early clinical deterioration, and a tailored nutritional care plan should be established for malnourished individuals, to improve their clinical outcomes.

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“…Fungi are associated with cutaneous infections, invasive fungal infections, and nosocomial blood infections or fungemia. Sepsis from fungemia also contributes to high mortality rates, particularly where Candida is the causative agent of the disease [ 35 ]. Antifungal and biocidal resistance and a lack of biocompatible therapeutic options for IFIs contributes greatly to the disease prevalence, where MDR and pan drug resistance is common amongst many nosocomial species including Candida albicans , non- albicans Candida strains (NAC), Cryptococcus, Aspergillus , and numerous dermatophyte species [ 4 ].…”

Section: Clinical Significance Of Who Pathogen Listmentioning

confidence: 99%

Pathogenic Drug Resistant Fungi: A Review of Mitigation Strategies

Garvey

Rowan²

2023

IJMS

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Fungal pathogens cause significant human morbidity and mortality globally, where there is a propensity to infect vulnerable people such as the immunocompromised ones. There is increasing evidence of resistance to antifungal drugs, which has significant implications for cutaneous, invasive and bloodstream infections. The World Health Organization (WHO) published a priority list of fungal pathogens in October 2022, thus, highlighting that a crisis point has been reached where there is a pressing need to address the solutions. This review provides a timely insight into the challenges and implications on the topic of antifungal drug resistance along with discussing the effectiveness of established disease mitigation modalities and approaches. There is also a need to elucidate the cellular and molecular mechanisms of fungal resistance to inform effective solutions. The established fungal decontamination approaches are effective for medical device processing and sterilization, but the presence of pathogenic fungi in recalcitrant biofilms can lead to challenges, particularly during cleaning. Future design ideas for implantable and reusable medical devices should consider antifungal materials and appropriates for disinfection, and where it is relevant, sterilization. Preventing the growth of mycotoxin-producing fungi on foods through the use of appropriate end-to-end processes is advisable, as mycotoxins are recalcitrant and challenging to eliminate once they have formed.

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Mortality and risk factor analysis for Candida blood stream infection: A three-year retrospective study

Cited by 18 publications

References 30 publications

Changing Trends of Candida Species and Antifungal Susceptibility Profile of Candida Bloodstream Isolates: A 5-Year Retrospective Survey

Changing Trends of Candida Species and Antifungal Susceptibility Profile of Candida Bloodstream Isolates: A 5-Year Retrospective Survey

Impact of Nutritional Assessment on the Clinical Outcomes of Patients with Non-albicans Candidemia: A Multicenter Study

Pathogenic Drug Resistant Fungi: A Review of Mitigation Strategies

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