Uma Devi P
Assistant Professor in the Department of Pharmacology
Title: Challenging clinical scenario of blood stream candida infections – An Indian experience
Biography
Biography: Uma Devi P
Abstract
Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The truernburden of candidemia in India is not clear. Thus, this study was conducted to evaluate the clinical characteristics, speciesrndistribution, antifungal susceptibility and outcome of candidemia at our hospital. A total of 165 episodes of Candida BSI werernidentified between January 2012 and April 2014, with 115 episodes occurring in adult patients. Most of the episodes occurredrnin males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive carernunit (65.2%) at the time of diagnosis. Majority of the candidemia episodes were found in the general medicine departmentrn(23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & hematology (13%). Risk factors identifiedrnwere prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinaryrncatheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilationrn(43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C.rnalbicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C.rnkrusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans).rnMortality was noted in 51 patients (44.3%). To conclude, rapid changes in the rate of infection, potential risk factors, andrnemergence of non-albicans Candida demand continued surveillance of this serious BSI.