Abdul Hakeem O Al Thaqafi1, Fayssal M Farahat2, Maher I Al Harbi3, Abdul Fattah W Al Amri4, John R Perfect5. 1. College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU- HS), Jeddah, Saudi Arabia; Section of Infectious Diseases, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 9515, 21423 Jeddah, Saudi Arabia. Electronic address: thaqafiao1@ngha.med.sa. 2. College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU- HS), Jeddah, Saudi Arabia; Section of Infectious Diseases, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 9515, 21423 Jeddah, Saudi Arabia; Department of Community Medicine and Public Health, Faculty of Medicine, Menoufia University, Egypt. 3. Section of Infectious Diseases, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 9515, 21423 Jeddah, Saudi Arabia. 4. College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU- HS), Jeddah, Saudi Arabia; Division of Microbiology, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia. 5. Department of Medicine, Duke University Medical Centre, Durham, North Carolina, USA.
Abstract
OBJECTIVES: To assess the epidemiological pattern of Candida bloodstream infection (BSI) over an 8-year period (2002-2009) in King Abdulaziz Medical City, western Saudi Arabia. METHOD: A retrospective chart review was performed. RESULTS: A total of 258 BSI were identified in 134 males (53.2%) and 118 females (46.8%). There were 86 (34.1%) cases of Candida albicans and 166 (65.9%) non-albicans Candida species. Malignancy was independently associated with the development of candidemia by non-albicans Candida species (odds ratio 3.24, 95% confidence interval 1.25-8.41). Fluconazole in vitro susceptibility was 38.5% for C. albicans and 52.5% for other Candida species. The overall, crude 12-month mortality rate was 50% for C. albicans and 57.8% for non-albicans Candida species. CONCLUSIONS: The antifungal resistance coinciding with a change in the epidemiologic pattern of candidemia identified in this study is alarming and urges the need for a review of empiric antifungal therapy and potential contributing environmental factors.
OBJECTIVES: To assess the epidemiological pattern of Candida bloodstream infection (BSI) over an 8-year period (2002-2009) in King Abdulaziz Medical City, western Saudi Arabia. METHOD: A retrospective chart review was performed. RESULTS: A total of 258 BSI were identified in 134 males (53.2%) and 118 females (46.8%). There were 86 (34.1%) cases of Candida albicans and 166 (65.9%) non-albicans Candida species. Malignancy was independently associated with the development of candidemia by non-albicans Candida species (odds ratio 3.24, 95% confidence interval 1.25-8.41). Fluconazole in vitro susceptibility was 38.5% for C. albicans and 52.5% for other Candida species. The overall, crude 12-month mortality rate was 50% for C. albicans and 57.8% for non-albicans Candida species. CONCLUSIONS: The antifungal resistance coinciding with a change in the epidemiologic pattern of candidemia identified in this study is alarming and urges the need for a review of empiric antifungal therapy and potential contributing environmental factors.
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