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. 2022 May-Aug;10(2):125-130.
doi: 10.4103/sjmms.sjmms_625_21. Epub 2022 Apr 28.

Clinical Characteristics and Outcome of Candidemia: Experience from a Tertiary Referral Center in Saudi Arabia

Hind Alhatmi  1 , Sarah Almansour  1 , Reem Abanamy  1 , Abdullah Akbar  1 , Mohammed Abalkhail  1 , Ahmad Alharbi  1   2   3 , Abdulrahman Alsaedy  1   2   3 , Ebrahim Mahmoud  1   2   3 , Bassam Alalwan  4 , Sameera AlJohani  4 , Omar S Aldibasi  3 , Mohammad Bosaeed  1   2   3 , Adel Alothman  1   2   3
Affiliations

Clinical Characteristics and Outcome of Candidemia: Experience from a Tertiary Referral Center in Saudi Arabia

Hind Alhatmi et al. Saudi J Med Med Sci. 2022 May-Aug.

Abstract

Background: Candida bloodstream infections cause significant excess morbidity and mortality in the health-care setting. There is limited evidence regarding Candida species causing invasive infections in Saudi Arabia.

Objective: To identify Candida species causing bloodstream infection and determine the clinical outcome and factors associated with mortality in a tertiary center in Saudi Arabia.

Materials and methods: This retrospective study included all cases of positive blood culture for Candida in patients admitted to King Abdulaziz Medical City, a tertiary care center in Riyadh, Saudi Arabia, between January 1, 2013 and June 30, 2019.

Results: A total of 532 patients with candidemia were identified (male: 55.4%; mean age: 54 ± 26.2 years). The most common Candida species isolated was Candida albicans (26.7%), followed by Candida glabrata (22.7%), Candida parapsilosis (22.2%), and Candida tropicalis (18.4%). Non-albicans candidemia was more common in patients with diabetes (76.7%; P = 0.0560), neutropenia (89.8%; P = 0.0062), recent exposure to fluconazole (85.7%; P = 0.0394), and active chemotherapy (83.1%; P = 0.0128). In non-albicans, susceptibility to fluconazole varied from 95.9% with C. tropicalis to 41.5% with C. parapsilosis; nonetheless, all species were highly susceptible to echinocandins. The overall 30- and 90-day mortality rates were 39.9% and 56.4%, respectively. The mortality rate was nonsignificantly higher with non-albicans species at 30 days (41.2% vs. 35.9%; P = 0.2634) and 90 days (58.2% vs. 51.4%; P = 0.1620).

Conclusion: This study found a changing pattern in the Candida species causing bloodstream infections and an epidemiological shift toward more non-albicans Candida species in Saudi Arabia.

Keywords: Candida albicans; Candidemia; Saudi Arabia; invasive candidiasis; nonalbicans; susceptibility.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of the common Candida species causing bloodstream infection over the study period
See this image and copyright information in PMC

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