SEARCHCOHORTinfectious disease, epidemiology

cohort·infectious disease, epidemiology, critical care, internal medicine, clinical trial·PMC10434190

Six-Year Retrospective Analysis of Epidemiology, Risk Factors, and Antifungal Susceptibilities of Candidiasis from a Tertiary Care Hospital in South China

Microbiology Spectrum · 11 authors, 10 centres

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TL;DR

Candida albicans was the most common species (64.25%), and central venous catheter was an independent risk factor for both C. albicans and non-C. albicans candidemia.

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Candida albicans was the most common species (64.25%), and central venous catheter was an independent risk factor for both C. albicans and non-C. albicans candidemia. Mortality rates were not statistically significant between C. albicans and non-C. albicans infections. Candidemia cases caused by C. tropicalis and C. glabrata had significantly lower azole susceptibility than non-candidemia-causing isolates. The study provides guidance for empirical therapy and highlights the need for infection control measures.

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cohort

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infectious disease

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ORIGINAL PAPER

PMC10434190

Six-Year Retrospective Analysis of Epidemiology, Risk Factors, and Antifungal Susceptibilities of Candidiasis from a Tertiary Care Hospital in South China

Microbiology Spectrum

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ABSTRACT

ABSTRACT Candidiasis is a life-threatening disease that increases mortality in critically ill patients. However, such epidemiological data are still lacking in underdeveloped regions of China. A retrospective analysis (2016 to 2021) was conducted in Meizhou People’s Hospital, China to study the burden of candidiasis, particularly candidemia, and antifungal susceptibilities of the species among hospitalized patients. Of the 7,864 candidiasis cases, 461 (5.86%) were candidemia cases. Candida albicans (64.25%) was the most identified species, followed by C. tropicalis (12.61%), C. glabrata (10.79%), and C. parapsilosis (9.79%). In non- C. albicans (NCA) candidemia cases, the number of C. glabrata cases was higher (102/461, 22.37%) than C. tropicalis (64/461, 14.04%). Gastrointestinal pathology, respiratory dysfunctions, septic shock, and malignancies were common underlying comorbidities, respectively. A central venous catheter was an independent risk factor for both C. albicans and NCA candidemia. The mortality rate was not statistically significant for either C. albicans or NCA. Amphotericin B and 5-flucytosine were highly effective (98 to 100%), while azoles were least effective (67.74 to 95.66%). Candidemia cases caused by C. tropicalis and C. glabrata had significantly lower azole susceptibility than non-candidemia-causing isolates. This study provides valuable information for prescribers to choose the right empirical therapy, for researchers to explore different resistance mechanisms, and for health care managers to control candidiasis better. IMPORTANCE This study provides important information on the burden of candidiasis, particularly candidemia, and the antifungal susceptibility of Candida species among hospitalized patients in an underdeveloped region of China. First, the finding that azoles were least effective against Candida species causing candidemia is particularly noteworthy, as it suggests the possibility of resistance to this class of antifungal agents. This information can guide the choice of empirical therapy and help in the selection of appropriate antifungal agents for the treatment of candidemia, thereby reducing the risk of resistance development. Second, the study provides important information for researchers to explore different resistance mechanisms in Candida species. Finally, the study has important implications for health care managers in controlling the spread of candidiasis. The high prevalence of candidemia cases in the study highlights the need for appropriate infection control measures to prevent the spread of the disease.

CITATION EXPORT

Hazrat Bilal, Dongxing Zhang, Muhammad Shafiq et al.. Six-Year Retrospective Analysis of Epidemiology, Risk Factors, and Antifungal Susceptibilities of Candidiasis from a Tertiary Care Hospital in South China. Microbiology Spectrum. (2023). https://doi.org/10.1128/spectrum.00708-23

AUTHORS

11 · 10 CENTRES

Hazrat Bilal, Dongxing Zhang, Muhammad Shafiq, Muhammad Nadeem Khan, Canhua chen, Sabir Khan, Qian Wang, Lin Cai, Rehmat Islam, Haibin Hu, Yuebin Zeng

a Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
b Department of Dermatology, Meizhou Dongshan Hospital, Meizhou, Guangdong Province, China
c Department of Dermatology, Meizhou People’s Hospital, Meizhou, Guangdong Province, China
d Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, China
e Faculty of Biological Sciences, Department of Microbiology, Quaid-I-Azam University, Islamabad, Pakistan
f Clinical Laboratory, Meizhou People's Hospital, Meizhou, Guangdong Province, China
g Key Laboratory of Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
h First Clinical Medical College, Guangdong Medical University, Zhanjiang, China
i Department of Medical-Surgical and Experimental Sciences, University of Sassari Neurology Unit, Azienza Ospedaliera Universitaria (AOU) Sassari, Italy
Institut National de Santé Publique du Québec

EDITOR / REVIEWER

Sadjia Bekal