Adrian Kreusch1, Alan S Karstaedt. 1. Division of Infectious Diseases, Department of Medicine, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Bertsham, Johannesburg, South Africa.
Abstract
BACKGROUND: Studies on candidemia occurring among adults in Southern African are limited. We aimed to document the epidemiology of candidemia among adults in Soweto. METHODS: This was a retrospective hospital-based study in three discrete periods, involving 9 years, from 1990 to 2007. RESULTS: Two hundred and sixty-six patients were identified. Case rates were 2.8 cases/10 000 admissions in 1998-2002 and 3.6 episodes/10 000 hospitalizations in 2005-2007. In 1990, Candida albicans caused 62% and Candida tropicalis caused 23% of episodes. In 2005-2007, major species were C. albicans (46%), Candida parapsilosis (25%), and Candida glabrata (23%), with little change compared to 1998-2002. Major predisposing conditions were abdominal surgery (43%), HIV infection (19% in 2005-2007), trauma (16%), diabetes mellitus (12%), and cancer (8%). General wards superseded intensive care as the major diagnostic setting in 2005-2007. The crude mortality was 60%. Among 22 HIV-infected patients with a median CD4 cell count of 68/μl, three were of community-onset. C. albicans caused 73% of cases. Five patients had another predisposing condition and five had central venous catheters. The mortality was 73%. CONCLUSIONS: Soweto has a pattern of Candida species different from other continents. HIV infection and trauma were important predisposing conditions.
BACKGROUND: Studies on candidemia occurring among adults in Southern African are limited. We aimed to document the epidemiology of candidemia among adults in Soweto. METHODS: This was a retrospective hospital-based study in three discrete periods, involving 9 years, from 1990 to 2007. RESULTS: Two hundred and sixty-six patients were identified. Case rates were 2.8 cases/10 000 admissions in 1998-2002 and 3.6 episodes/10 000 hospitalizations in 2005-2007. In 1990, Candida albicans caused 62% and Candida tropicalis caused 23% of episodes. In 2005-2007, major species were C. albicans (46%), Candida parapsilosis (25%), and Candida glabrata (23%), with little change compared to 1998-2002. Major predisposing conditions were abdominal surgery (43%), HIV infection (19% in 2005-2007), trauma (16%), diabetes mellitus (12%), and cancer (8%). General wards superseded intensive care as the major diagnostic setting in 2005-2007. The crude mortality was 60%. Among 22 HIV-infectedpatients with a median CD4 cell count of 68/μl, three were of community-onset. C. albicans caused 73% of cases. Five patients had another predisposing condition and five had central venous catheters. The mortality was 73%. CONCLUSIONS: Soweto has a pattern of Candida species different from other continents. HIV infection and trauma were important predisposing conditions.
Authors: Agnieszka Lewandowska; Corinne P Soutar; Alexander I Greenwood; Evgeny Nimerovsky; Ashley M De Lio; Jordan T Holler; Grant S Hisao; Anuj Khandelwal; Jiabao Zhang; Anna M SantaMaria; Charles D Schwieters; Taras V Pogorelov; Martin D Burke; Chad M Rienstra Journal: Nat Struct Mol Biol Date: 2021-12-09 Impact factor: 18.361