Research Article
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Year 2019, Volume: 41 Issue: 2, 318 - 327, 30.06.2019
https://doi.org/10.7197/223.vi.553114

Abstract

References

  • Eggimann P, Garbino J, Pittet D. Epidemiology of Candida species infections in critically ill non-immunosuppressed patients. Lancet Infect Dis. 2003 Nov;3(11):685-702.
  • Calandra T, Roberts JA, Antonelli M, Bassetti M, Vincent JL. Diagnosis and management of invasive candidiasis in the ICU: an updated approach to an old enemy. Crit Care. 2016 May 27;20(1):125.
  • Sardi JC, Scorzoni L, Bernardi T, Fusco-Almeida AM, Mendes Giannini MJ. Candida species: Current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options. J Med Microbiol. 2013 Jan;62(Pt 1):10-24.
  • Arendrup MC, Patterson TF. Multidrug-Resistant Candida: Epidemiology, Molecular Mechanisms, and Treatment. J Infect Dis. 2017 Aug 15;216(suppl_3):445-51
  • Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L,et al. Executive Summary: Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016 Feb 15;62(4):409-17.
  • Delaloye J, Calandra T. Invasive candidiasis as a cause of sepsis in the critically ill patient. Virulence. 2014 Jan 1;5(1):161-9. 7. Cerikcioglu N. Candida Türleri. Enfeksiyon Hastalıkları ve Klinik Mikrobiyolojisi, Editörler: Topcu AW, Söyletir G, Doğanay M. Nobel Tıp Kitabevleri, 4.Baskı, Cilt:2, 2017; S: 2115-30.
  • Cerikcioglu N. Candida Türleri. Enfeksiyon Hastalıkları ve Klinik Mikrobiyolojisi, Editörler: Topcu AW, Söyletir G, Doğanay M. Nobel Tıp Kitabevleri, 4.Baskı, Cilt:2, 2017; S: 2115-30.
  • Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health-care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008 Jun;36(5):309-32.
  • Pfaller MA, Diekema DJ, Gibbs DL, Newell VA, Ellis D, Tullio V, et al. Global Antifungal Surveillance Group. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-year analysis of susceptibilities of Candida Species to fluconazole and voriconazole as determined by CLSI standardized disk diffusion. J Clin Microbiol. 2010 Apr;48(4):1366-77.
  • Cornistein W, Mora A, Orellana N, Capparelli FJ, del Castillo M. Candida: epidemiology and risk factors for non-albicans species. Enferm Infecc Microbiol Clin. 2013 Jun-Jul;31(6):380-4.
  • Takakura S, Fujihara N, Saito T, Kudo T, Iinuma Y, Ichiyama S. National surveillance of species distribution in blood isolates of Candida species in Japan and their susceptibility to six antifungal agents including voriconazole and micafungin. J Antimicrob Chemother. 2004 Feb;53(2):283-9.
  • Çiçek B, Yılmaz H, Mutlu Yılmaz E, Esen Ş, Birinci A. Investigation of the changes in Candida epidemiology. Mikrobiyol Bul. 2015 Jul;49(3):423-31.
  • Temiz H, Temiz S, Kaya Ş. Çeşitli Klinik Örneklerden İzole Edilen Kandida Türlerinin Dağılımı ve Antifungal Duyarlılıkları. Okmeydanı Tıp Dergisi 2015; 31(1):13-7.
  • Turhan O, Ozhak-Baysan B, Zaragoza O, Er H, Sarıtas ZE, Ongut G, et al. Evaluation of MALDI-TOF-MS for the Identification of Yeast Isolates Causing Bloodstream Infection. Clin Lab. 2017 Apr 1;63(4):699-703.
  • Vazquez JA. Invasive fungal infections in the intensive care unit. Semin Respir Crit Care Med. 2010 Feb;31(1):79-86.
  • Erdem F, Tuncer EG, Oral B, Karakoç E, Demiröz AP, Tülek N. Candida Türlerine Bağlı Nozokomiyal Enfeksiyonların Epidemiyolojik ve Mikrobiyolojik Açıdan Değerlendirilmesi. Mikrobiyol Bul 2012;46(4):637-48.
  • Hazırolan G. Ankara Numune Eğitim ve Araştırma Hastanesinde hastane enfeksiyonu etkeni olarak izole edilen candida suşlarının dağılımı (2010-2015). Turk Hij Den Biyol Derg. 2018;75 (1): 21-8.
  • Yang SP, Chen YY, Hsu HS, Wang FD, Chen LY, Fung CP. A risk factor analysis of Health-care-associated fungal infections in an intensive care unit: a retrospective cohort study. BMC Infect Dis. 2013 Jan 9;13:10.
  • Lamoth F, Lockhart SR, Berkow EL, Calandra T. Changes in the epidemiological landscape of invasive candidiasis. J Antimicrob Chemother. 2018 Jan 1;73(suppl_1):i4-i13.
  • Eliakim-Raz N, Babaoff R, Yahav D, Yanai S, Shaked H, Bishara J. Epidemiology, microbiology, clinical characteristics, and outcomes of candidemia in internal medicine wards-a retrospective study. Int J Infect Dis. 2016 Nov;52:49-54.
  • Ulu Kılıç A, Alp E, Cevahir F, Ture Z, Yozgat N. Epidemiology and cost implications of candidemia, a 6-year analysis from a developing country. Mycoses. 2017 Mar;60(3):198-203.
  • Tan BH, Chakrabarti A, Li RY, Patel AK, Watcharananan SP, Liu Z, et al; Asia Fungal Working Group (AFWG). Incidence and species distribution of candidaemia in Asia: a laboratory-based surveillance study. Clin Microbiol Infect. 2015 Oct;21(10):946-53.
  • Falcone M, Tiseo G, Tascini C, Russo A, Sozio E, Raponi G, et al. Assessment of risk factors for candidemia in non-neutropenic patients hospitalized in Internal Medicine wards: A multicenter study. Eur J Intern Med. 2017 Jun;41:33-8.
  • Yapar N, Pullukcu H, Avkan-Oguz V, Sayin-Kutlu S, Ertugrul B, Sacar S. Evaluation of species distribution and risk factors of candidemia: a multicenter case-control study. Med Mycol. 2011 Jan;49(1):26-31.
  • Orasch C, Marchetti O, Garbino J, Schrenzel J, Zimmerli S, Mühlethaler K, FUNGINOS. Candida species distribution and antifungal susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing and new vs. old Clinical and Laboratory Standards Institute clinical breakpoints: a 6-year prospective candidaemia survey from the fungal infection network of Switzerland. Clin Microbiol Infect. 2014 Jul;20(7):698-705.
  • Al-Dorzi HM, Sakkijha H, Khan R, Aldabbagh T, Toledo A, Ntinika P, et al. Invasive Candidiasis in Critically Ill Patients: A Prospective Cohort Study in Two Tertiary Care Centers. J Intensive Care Med. 2018 Jan 1:885066618767835.
  • Posteraro B, Spanu T, Fiori B, De Maio F, De Carolis E, Giaquinto A, et al. Antifungal susceptibility profiles of bloodstream yeast isolates by Sensititre YeastOne over nine years at a large Italian teaching hospital. Antimicrob Agents Chemother. 2015 Jul;59(7):3944-55.
  • Mohamed NA, Pathmanathan SG, Hussin H, Zaini AB. Distribution and Antifungal Susceptibility Pattern of Candida species at a Tertiary Hospital in Malaysia. J Infect Dev Ctries 2018; 12(2):102-8.29. Aydemir Ö, Demiray T, Köroğlu M, Aydemir Y, Altındiş M. Emerge of non-albicans Candida species; evaluation of Candida species and antifungal susceptibilities according yo years. Biomed Res. 2017; 28 (6): 2820-25.
  • Aydemir Ö, Demiray T, Köroğlu M, Aydemir Y, Altındiş M. Emerge of non-albicans Candida species; evaluation of Candida species and antifungal susceptibilities according yo years. Biomed Res. 2017; 28 (6): 2820-25.
  • Kucukates E, Gultekin NN, Alisan Z, Hondur N, Ozturk R. Identification of Candida species and susceptibility testing with Sensititre YeastOne microdilution panel to 9 antifungal agents. Saudi Med J. 2016 Jul;37(7):750-7.

Epidemiological analysis of Nosocomial Candida infections: Experience of a university hospital

Year 2019, Volume: 41 Issue: 2, 318 - 327, 30.06.2019
https://doi.org/10.7197/223.vi.553114

Abstract

Objective: A retrospective
investigation was made in a university hospital setting of the distribution of
Candida infections in terms of species, different clinical features of
infections, risk factors for candidemia caused by these fungi and their
antifungal susceptibilities.

Method: This study was
conducted between January 1st 2014 and December 31st 2017.
Patients included in the study were those diagnosed with candida infection as a
result of candida species, isolated from at least one clinical sample of those
taken from hospitalized patients, including blood, urine and other clinical
samples, and who were then administered antifungal therapy. The identification
of candida species was performed using Matrix-Assisted Laser
Desorption/Ionization Time-of-Mass Spectrometry (MALDI-TOF MS).

Results: During the study period, the candida
infection rate was found to be 5.86% in the 2760 episodes of infection and the
incidence of candida infection was found to be 0.35 in 1000 bed days. The most
common infection site for candida was the urinary tract (61.1%), followed by the
blood-stream (31.5%). In 66% of all candida infections, Candida albicans was defined as the causative agent. The distribution
of Candida glabrata, Candida tropicalis, Candida parapsilosis, Candida
lusiteniae,
Candida krusei and Candida kefyr were determined as 9.9%,
9.3%, 4.9%, 2.5%, 1.9% and 1.2%, respectively. The sensitivity to fluconazole
and amphotericin B was determined as 97.2% and 99.1% in the C. albicans isolates,
respectively. The sensitivity ratios for both
fluconazole and amphotericin B were determined as 78.2% in the non-albicans
strains. Multivariate logistic regression analysis showed that total  parenteral nutrition (TPN) [Odds ratio (OR)
3.69, 95% Confidence interval, 1.595-8.570; p=0.002] was an independent risk
factor for candidemia in patients with candida infection.







Conclusions: C. albicans
were the most encountered species in candida infections in our hospital. TPN  was determined as an independent risk factor
for the development of candidemia. Determinations of the species distribution
of fungal infections and the antifungal sensitivity are important for the
selection of effective treatment.

References

  • Eggimann P, Garbino J, Pittet D. Epidemiology of Candida species infections in critically ill non-immunosuppressed patients. Lancet Infect Dis. 2003 Nov;3(11):685-702.
  • Calandra T, Roberts JA, Antonelli M, Bassetti M, Vincent JL. Diagnosis and management of invasive candidiasis in the ICU: an updated approach to an old enemy. Crit Care. 2016 May 27;20(1):125.
  • Sardi JC, Scorzoni L, Bernardi T, Fusco-Almeida AM, Mendes Giannini MJ. Candida species: Current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options. J Med Microbiol. 2013 Jan;62(Pt 1):10-24.
  • Arendrup MC, Patterson TF. Multidrug-Resistant Candida: Epidemiology, Molecular Mechanisms, and Treatment. J Infect Dis. 2017 Aug 15;216(suppl_3):445-51
  • Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L,et al. Executive Summary: Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016 Feb 15;62(4):409-17.
  • Delaloye J, Calandra T. Invasive candidiasis as a cause of sepsis in the critically ill patient. Virulence. 2014 Jan 1;5(1):161-9. 7. Cerikcioglu N. Candida Türleri. Enfeksiyon Hastalıkları ve Klinik Mikrobiyolojisi, Editörler: Topcu AW, Söyletir G, Doğanay M. Nobel Tıp Kitabevleri, 4.Baskı, Cilt:2, 2017; S: 2115-30.
  • Cerikcioglu N. Candida Türleri. Enfeksiyon Hastalıkları ve Klinik Mikrobiyolojisi, Editörler: Topcu AW, Söyletir G, Doğanay M. Nobel Tıp Kitabevleri, 4.Baskı, Cilt:2, 2017; S: 2115-30.
  • Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health-care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008 Jun;36(5):309-32.
  • Pfaller MA, Diekema DJ, Gibbs DL, Newell VA, Ellis D, Tullio V, et al. Global Antifungal Surveillance Group. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-year analysis of susceptibilities of Candida Species to fluconazole and voriconazole as determined by CLSI standardized disk diffusion. J Clin Microbiol. 2010 Apr;48(4):1366-77.
  • Cornistein W, Mora A, Orellana N, Capparelli FJ, del Castillo M. Candida: epidemiology and risk factors for non-albicans species. Enferm Infecc Microbiol Clin. 2013 Jun-Jul;31(6):380-4.
  • Takakura S, Fujihara N, Saito T, Kudo T, Iinuma Y, Ichiyama S. National surveillance of species distribution in blood isolates of Candida species in Japan and their susceptibility to six antifungal agents including voriconazole and micafungin. J Antimicrob Chemother. 2004 Feb;53(2):283-9.
  • Çiçek B, Yılmaz H, Mutlu Yılmaz E, Esen Ş, Birinci A. Investigation of the changes in Candida epidemiology. Mikrobiyol Bul. 2015 Jul;49(3):423-31.
  • Temiz H, Temiz S, Kaya Ş. Çeşitli Klinik Örneklerden İzole Edilen Kandida Türlerinin Dağılımı ve Antifungal Duyarlılıkları. Okmeydanı Tıp Dergisi 2015; 31(1):13-7.
  • Turhan O, Ozhak-Baysan B, Zaragoza O, Er H, Sarıtas ZE, Ongut G, et al. Evaluation of MALDI-TOF-MS for the Identification of Yeast Isolates Causing Bloodstream Infection. Clin Lab. 2017 Apr 1;63(4):699-703.
  • Vazquez JA. Invasive fungal infections in the intensive care unit. Semin Respir Crit Care Med. 2010 Feb;31(1):79-86.
  • Erdem F, Tuncer EG, Oral B, Karakoç E, Demiröz AP, Tülek N. Candida Türlerine Bağlı Nozokomiyal Enfeksiyonların Epidemiyolojik ve Mikrobiyolojik Açıdan Değerlendirilmesi. Mikrobiyol Bul 2012;46(4):637-48.
  • Hazırolan G. Ankara Numune Eğitim ve Araştırma Hastanesinde hastane enfeksiyonu etkeni olarak izole edilen candida suşlarının dağılımı (2010-2015). Turk Hij Den Biyol Derg. 2018;75 (1): 21-8.
  • Yang SP, Chen YY, Hsu HS, Wang FD, Chen LY, Fung CP. A risk factor analysis of Health-care-associated fungal infections in an intensive care unit: a retrospective cohort study. BMC Infect Dis. 2013 Jan 9;13:10.
  • Lamoth F, Lockhart SR, Berkow EL, Calandra T. Changes in the epidemiological landscape of invasive candidiasis. J Antimicrob Chemother. 2018 Jan 1;73(suppl_1):i4-i13.
  • Eliakim-Raz N, Babaoff R, Yahav D, Yanai S, Shaked H, Bishara J. Epidemiology, microbiology, clinical characteristics, and outcomes of candidemia in internal medicine wards-a retrospective study. Int J Infect Dis. 2016 Nov;52:49-54.
  • Ulu Kılıç A, Alp E, Cevahir F, Ture Z, Yozgat N. Epidemiology and cost implications of candidemia, a 6-year analysis from a developing country. Mycoses. 2017 Mar;60(3):198-203.
  • Tan BH, Chakrabarti A, Li RY, Patel AK, Watcharananan SP, Liu Z, et al; Asia Fungal Working Group (AFWG). Incidence and species distribution of candidaemia in Asia: a laboratory-based surveillance study. Clin Microbiol Infect. 2015 Oct;21(10):946-53.
  • Falcone M, Tiseo G, Tascini C, Russo A, Sozio E, Raponi G, et al. Assessment of risk factors for candidemia in non-neutropenic patients hospitalized in Internal Medicine wards: A multicenter study. Eur J Intern Med. 2017 Jun;41:33-8.
  • Yapar N, Pullukcu H, Avkan-Oguz V, Sayin-Kutlu S, Ertugrul B, Sacar S. Evaluation of species distribution and risk factors of candidemia: a multicenter case-control study. Med Mycol. 2011 Jan;49(1):26-31.
  • Orasch C, Marchetti O, Garbino J, Schrenzel J, Zimmerli S, Mühlethaler K, FUNGINOS. Candida species distribution and antifungal susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing and new vs. old Clinical and Laboratory Standards Institute clinical breakpoints: a 6-year prospective candidaemia survey from the fungal infection network of Switzerland. Clin Microbiol Infect. 2014 Jul;20(7):698-705.
  • Al-Dorzi HM, Sakkijha H, Khan R, Aldabbagh T, Toledo A, Ntinika P, et al. Invasive Candidiasis in Critically Ill Patients: A Prospective Cohort Study in Two Tertiary Care Centers. J Intensive Care Med. 2018 Jan 1:885066618767835.
  • Posteraro B, Spanu T, Fiori B, De Maio F, De Carolis E, Giaquinto A, et al. Antifungal susceptibility profiles of bloodstream yeast isolates by Sensititre YeastOne over nine years at a large Italian teaching hospital. Antimicrob Agents Chemother. 2015 Jul;59(7):3944-55.
  • Mohamed NA, Pathmanathan SG, Hussin H, Zaini AB. Distribution and Antifungal Susceptibility Pattern of Candida species at a Tertiary Hospital in Malaysia. J Infect Dev Ctries 2018; 12(2):102-8.29. Aydemir Ö, Demiray T, Köroğlu M, Aydemir Y, Altındiş M. Emerge of non-albicans Candida species; evaluation of Candida species and antifungal susceptibilities according yo years. Biomed Res. 2017; 28 (6): 2820-25.
  • Aydemir Ö, Demiray T, Köroğlu M, Aydemir Y, Altındiş M. Emerge of non-albicans Candida species; evaluation of Candida species and antifungal susceptibilities according yo years. Biomed Res. 2017; 28 (6): 2820-25.
  • Kucukates E, Gultekin NN, Alisan Z, Hondur N, Ozturk R. Identification of Candida species and susceptibility testing with Sensititre YeastOne microdilution panel to 9 antifungal agents. Saudi Med J. 2016 Jul;37(7):750-7.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Medical Science Research Articles
Authors

Seyit Ali Büyüktuna 0000-0001-6518-7361

Mürşit Hasbek

Nazif Elaldı

Mustafa Gökhan Gözel

Cem Çelik

Aynur Engin

Mustafa Zahir Bakıcı

Mehmet Bakır

Publication Date June 30, 2019
Acceptance Date June 12, 2019
Published in Issue Year 2019Volume: 41 Issue: 2

Cite

AMA 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. CMJ. June 2019;41(2):318-327. doi:10.7197/223.vi.553114