Species distribution and antifungal susceptibility patterns of Candida isolated from critically ill patients with candidemia

Document Type : Original Article

Authors

1 Medical Microbiology and Immunology Department. Faculty of Medicine, Cairo University, Cairo, Egypt

2 Clinical and Chemical Pathology Department. Faculty of Medicine, Cairo University, Cairo, Egypt

3 Critical Care Medicine Department. Faculty of Medicine, Cairo University, Cairo, Egypt

Abstract

Background: Candidemia, the prevailing form of invasive candidiasis, is a serious medical condition with high fatality rates particularly among individuals who are critically ill. We conducted this study to investigate the distribution of Candida species and their susceptibility to different antifungal drugs among patients with candidemia in intensive care units. Methods: During one year, seventy-four Candida isolates were obtained from the blood of pediatric and adult patients in intensive care units of Kasr Alainy University hospitals. The Vitek-2 yeast identification system was employed to identify the isolates. Additionally, the antifungal susceptibility of all isolates was assessed using Vitek-2 system AST-YS08. Results: The age of patients with candidemia varied from 8 days to 85 years, with a higher occurrence observed among neonates and individuals aged 60-69 years. Higher rates of candidemia were observed in females than males (55.4% versus 44.6%). Among patients diagnosed with candidemia, Candida albicans was the most prevalent species, accounting for 52.7% of cases. Non-albicans Candida species represented 47.3% of cases; C. parapsilosis was the most predominant (18.9%), and C. tropicalis came in the second rank (16.2%). Fluconazole resistance among different Candida species was (20.3%), with no resistance recorded against amphotericin B, voriconazole, and micafungin. Conclusions: Candida albicans was the most commonly detected species, but there was an increased non-albicans Candida isolation rate. Candida isolates exhibited the highest resistance against fluconazole. Amphotericin B remained the most effective drug for treating Candida infections. The emergence of uncommon and multidrug-resistant Candida species highlights the need for surveillance and antifungal stewardship.

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