Abstract
References
- 1. McCarty TP, White CM, Pappas PG. Candidemia and Invasive Candidiasis. Infect Dis Clin North Am. 2021 Jun;35(2):389-413.
- 2. Keighley C, Cooley L, Morris AJ, Ritchie D, Clark JE, Boan P, Worth LJ; Australasian Antifungal Guidelines Steering Committee. Consensus guidelines for the diagnosis and management of invasive candidiasis in haematology, oncology and intensive care settings. Intern Med J. 2021 Nov;51 Suppl 7:89-117.
- 3. Bays DJ, Thompson GR 3rd. Fungal Infections of the Stem Cell Transplant Recipient and Hematologic Malignancy Patients. Infect Dis Clin North Am. 2019;33(2):545-566.
- 4. Antinori S, Milazzo L, Sollima S, Galli M, Corbellino M. Candidemia and invasive candidiasis in adults: A narrative review. Eur J Intern Med. 2016 Oct; 34:21-28.
- 5. Hazırolan G. Albicans-Dışı Candida türlerinin flukonazol, itrakonazol, vorikonazole in vitro duyarlılığının referans sıvı mikrodilüsyon yöntem ile araştırılması: yeni türe özgü klinik direnç sınır değerleri ve epidemiyolojik eşik değerlerinin uygulanması. Turk Mikrobiyol Cem Derg 2018; 48(1): 38-44.
- 6. https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_12.0_Breakpoint_Tables.pdf Retrieved August 15, 2022.
- 7. Mora Carpio AL, Climaco A. Fungemia Candidiasis. 2021 Aug 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- 8. Alves J, Palma P, Azevedo D, Rello J. Candidemia in the patient with malignancy. Hosp Pract (1995). 2018 Dec;46(5):246-252.
- 9. Lortholary O, Renaudat C, Sitbon K, Desnos-Ollivier M, Bretagne S, Dromer F; French Mycoses Study Group. The risk and clinical outcome of candidemia depending on underlying malignancy. Intensive Care Med. 2017 May;43(5):652-662.
- 10. Pieralli F, Azzini AM, Concia E, Lo Cascio G, Tedesco A, Benedetti V, Piredda S, Giusti M, Santini C, Zagarrì E, Fontanella A, Manfellotto D. Predicting candidemia in internal medicine departments: are we chasing the Holy Grail? Pol Arch Intern Med. 2021 Nov 30;131(11):16112.
- 11. Büyüktuna SA, Hasbek M, Elaldı N, Gözel MG, Çelik C, Engin A, Bakıcı MZ, Bakır M. Epidemiological analysis of Nosocomial Candida infections: Experience of a university hospital. Cumhuriyet Medical Journal. 2019;41(2): 318-327.
- 12. Pinto-Magalhães S, Martins A, Lacerda S, Filipe R, Prista-Leão B, Pinheiro D, Silva-Pinto A, Santos L. Candidemia in a Portuguese tertiary care hospital: Analysis of a 2-year period. J Mycol Med. 2019 Dec;29(4):320-324.
- 13. Siopi M, Tarpatzi A, Kalogeropoulou E, Damianidou S, Vasilakopoulou A, Vourli S, Pournaras S, Meletiadis J. Epidemiological Trends of Fungemia in Greece with a Focus on Candidemia during the Recent Financial Crisis: a 10-Year Survey in a Tertiary Care Academic Hospital and Review of Literature. Antimicrob Agents Chemother. 2020 Feb 21;64(3): e01516-19.
- 14. Israel S, Amit S, Israel A, Livneh A, Nir-Paz R, Korem M. The Epidemiology and Susceptibility of Candidemia in Jerusalem, Israel. Front Cell Infect Microbiol. 2019 Oct 11; 9:352.
- 15. Wu PF, Liu WL, Hsieh MH, Hii IM, Lee YL, Lin YT, Ho MW, Liu CE, Chen YH, Wang FD. Epidemiology and antifungal susceptibility of candidemia isolates of non-albicans Candida species from cancer patients. Emerg Microbes Infect. 2017 Oct 11;6(10): e87.
- 16. Jamiu AT, Albertyn J, Sebolai OM, Pohl CH. Update on Candida krusei, a potential multidrug-resistant pathogen. Med Mycol. 2021 Jan 4;59(1):14-30.
- 17. Berkow EL, Lockhart SR. Fluconazole resistance in Candida species: a current perspective. Infect Drug Resist. 2017 Jul 31; 10:237-245.
- 18. Candel FJ, Pazos Pacheco C, Ruiz-Camps I, Maseda E, Sánchez-Benito MR, Montero A, Puig M, Gilsanz F, Aguilar J, Matesanz M. Update on management of invasive candidiasis. Rev Esp Quimioter. 2017;30(6):397-406.
- 19. Sanguinetti M, Posteraro B, Lass-Flörl C. Antifungal drug resistance among Candida species: mechanisms and clinical impact. Mycoses. 2015 Jun;58 Suppl 2:2-13.
Patients with the Diagnosis of Malignancy Followed Up with Candidemia in a Tertiary University Hospital: Analysis of Species and Resistance
Abstract
Introduction: The incidence of Candidemia, which is a significant cause of morbidity and mortality, is increasing. Patients with a diagnosis of malignancy, who use immunosuppressants, and who require follow-up in the intensive care unit are at high risk for Candidemia. The incidence and resistance patterns of Candida species may vary depending on population, geographical location, and previous antifungal exposure. It was aimed to identify Candida spp. isolated from blood culture samples of patients diagnosed with malignancy for the species level, and to determine their antifungal drug susceptibility, in this study.
Materials and Methods: In this study, the results of the samples with growth in blood cultures between January 2016 and July-2022 were examined retrospectively. The patients with a diagnosis of Candida spp. fungal growth in at least one blood culture set during hospitalization and the patients with a diagnosis of malignancy defined as candidemia and treated with antifungal were included in the study.
Results: Candida albicans growth was detected in 43.5% (10) of the blood cultures included in the study. Non-albicans species were isolated in a total of 13 blood cultures (56.5%): 30.4% (7) C. parapsilosis; 17.4% (4) C. glabrata; 4.3% (1) C. tropicalis; 4.3% (1) C. krusei. Very low resistance rates were determined against many antifungals such as Amphotericin B (0%), Micafungin (0%), Fluconazole (10%), Posaconazole (0%), Voriconazole (0%), and Anidulafungin (25%) for C. albicans isolates in our study. On the other hand, higher levels of resistance were observed for almost all antifungals for non-albicans species, the incidence of which has increased in recent years.
Discussion and Suggestions: The epidemiology of Candida infections has been changing in recent years. Although C. albicans is still the main reason for invasive Candidiasis in many clinical environments, a significant number of patients are now infected with non-albicans Candida species. Candida species may show differential susceptibility to commonly used antifungal agents. The susceptibility of Candida species to commonly used antifungal agents varies. As in our study, we believe that following the epidemiological data and antifungal susceptibility patterns of medical centers will allow effective empirical treatment and improve Candidemia prognosis.
References
- 1. McCarty TP, White CM, Pappas PG. Candidemia and Invasive Candidiasis. Infect Dis Clin North Am. 2021 Jun;35(2):389-413.
- 2. Keighley C, Cooley L, Morris AJ, Ritchie D, Clark JE, Boan P, Worth LJ; Australasian Antifungal Guidelines Steering Committee. Consensus guidelines for the diagnosis and management of invasive candidiasis in haematology, oncology and intensive care settings. Intern Med J. 2021 Nov;51 Suppl 7:89-117.
- 3. Bays DJ, Thompson GR 3rd. Fungal Infections of the Stem Cell Transplant Recipient and Hematologic Malignancy Patients. Infect Dis Clin North Am. 2019;33(2):545-566.
- 4. Antinori S, Milazzo L, Sollima S, Galli M, Corbellino M. Candidemia and invasive candidiasis in adults: A narrative review. Eur J Intern Med. 2016 Oct; 34:21-28.
- 5. Hazırolan G. Albicans-Dışı Candida türlerinin flukonazol, itrakonazol, vorikonazole in vitro duyarlılığının referans sıvı mikrodilüsyon yöntem ile araştırılması: yeni türe özgü klinik direnç sınır değerleri ve epidemiyolojik eşik değerlerinin uygulanması. Turk Mikrobiyol Cem Derg 2018; 48(1): 38-44.
- 6. https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_12.0_Breakpoint_Tables.pdf Retrieved August 15, 2022.
- 7. Mora Carpio AL, Climaco A. Fungemia Candidiasis. 2021 Aug 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- 8. Alves J, Palma P, Azevedo D, Rello J. Candidemia in the patient with malignancy. Hosp Pract (1995). 2018 Dec;46(5):246-252.
- 9. Lortholary O, Renaudat C, Sitbon K, Desnos-Ollivier M, Bretagne S, Dromer F; French Mycoses Study Group. The risk and clinical outcome of candidemia depending on underlying malignancy. Intensive Care Med. 2017 May;43(5):652-662.
- 10. Pieralli F, Azzini AM, Concia E, Lo Cascio G, Tedesco A, Benedetti V, Piredda S, Giusti M, Santini C, Zagarrì E, Fontanella A, Manfellotto D. Predicting candidemia in internal medicine departments: are we chasing the Holy Grail? Pol Arch Intern Med. 2021 Nov 30;131(11):16112.
- 11. Büyüktuna SA, Hasbek M, Elaldı N, Gözel MG, Çelik C, Engin A, Bakıcı MZ, Bakır M. Epidemiological analysis of Nosocomial Candida infections: Experience of a university hospital. Cumhuriyet Medical Journal. 2019;41(2): 318-327.
- 12. Pinto-Magalhães S, Martins A, Lacerda S, Filipe R, Prista-Leão B, Pinheiro D, Silva-Pinto A, Santos L. Candidemia in a Portuguese tertiary care hospital: Analysis of a 2-year period. J Mycol Med. 2019 Dec;29(4):320-324.
- 13. Siopi M, Tarpatzi A, Kalogeropoulou E, Damianidou S, Vasilakopoulou A, Vourli S, Pournaras S, Meletiadis J. Epidemiological Trends of Fungemia in Greece with a Focus on Candidemia during the Recent Financial Crisis: a 10-Year Survey in a Tertiary Care Academic Hospital and Review of Literature. Antimicrob Agents Chemother. 2020 Feb 21;64(3): e01516-19.
- 14. Israel S, Amit S, Israel A, Livneh A, Nir-Paz R, Korem M. The Epidemiology and Susceptibility of Candidemia in Jerusalem, Israel. Front Cell Infect Microbiol. 2019 Oct 11; 9:352.
- 15. Wu PF, Liu WL, Hsieh MH, Hii IM, Lee YL, Lin YT, Ho MW, Liu CE, Chen YH, Wang FD. Epidemiology and antifungal susceptibility of candidemia isolates of non-albicans Candida species from cancer patients. Emerg Microbes Infect. 2017 Oct 11;6(10): e87.
- 16. Jamiu AT, Albertyn J, Sebolai OM, Pohl CH. Update on Candida krusei, a potential multidrug-resistant pathogen. Med Mycol. 2021 Jan 4;59(1):14-30.
- 17. Berkow EL, Lockhart SR. Fluconazole resistance in Candida species: a current perspective. Infect Drug Resist. 2017 Jul 31; 10:237-245.
- 18. Candel FJ, Pazos Pacheco C, Ruiz-Camps I, Maseda E, Sánchez-Benito MR, Montero A, Puig M, Gilsanz F, Aguilar J, Matesanz M. Update on management of invasive candidiasis. Rev Esp Quimioter. 2017;30(6):397-406.
- 19. Sanguinetti M, Posteraro B, Lass-Flörl C. Antifungal drug resistance among Candida species: mechanisms and clinical impact. Mycoses. 2015 Jun;58 Suppl 2:2-13.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Basic Science Research Articles |
| Authors | |
| Publication Date | December 31, 2022 |
| Acceptance Date | December 29, 2022 |
| Published in Issue | Year 2022 |