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. 2021 Jan 19;10(1):82.
doi: 10.3390/pathogens10010082.

Predominance of Candida Glabrata among Non- albicans Candida Species in a 16-Year Study of Candidemia at a Tertiary Care Center in Lebanon

Aline El Zakhem  1 , Rachid Istambouli  1 , Maria Alkozah  1 , Amal Gharamti  1 , Mohamad Ali Tfaily  1 , Jean-Francois Jabbour  1 , George F Araj  2 , Hani Tamim  1 , Souha S Kanj  1
Affiliations

Predominance of Candida Glabrata among Non- albicans Candida Species in a 16-Year Study of Candidemia at a Tertiary Care Center in Lebanon

Aline El Zakhem et al. Pathogens. .

Abstract

Candidemia is associated with a high mortality rate, and its incidence is increasing worldwide with a rise in non-albicans candidemia (NAC). Epidemiologic data from Arab countries are scarce and there are no data from Lebanon; Methods: This is a single-center retrospective chart review of patients with candidemia in a tertiary care center in Lebanon from 2004 to 2019. We extracted data on patient characteristics, isolated Candida species antifungal susceptibility, management and outcomes; Results: We included 170 cases of candidemia. NAC was more common than albicans candidemia (64.7% vs. 35.3%). C. glabrata was the most common non-albicans species (37 isolates) followed by C. tropicalis (14). Recent use of antifungals was a risk factor for NAC (OR = 2.8, p = 0.01), while the presence of a central venous catheter was protective (OR = 0.41, p = 0.02). Fluconazole resistance was 12.5% in C. albicans and 21.5% in non-albicans spp. Mortality at 30 days was 55.5%, with no difference between NAC and albicans candidemia. It was higher in older and critically ill patients but lower in patients whose central venous catheter was removed after detecting fungemia; Conclusions: Candidemia is associated with high mortality in Lebanon, with a predominance of NAC and high prevalence of C. glabrata.

Keywords: Arab world; Candida glabrata; Lebanon; antifungal susceptibility; candidemia; invasive candidiasis; non-albicans Candida.

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Conflict of interest statement

The authors declare no conflict of interest.

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