Surveillance and characterization of Candida bloodstream infections in a Serbian tertiary care hospital

  • Predrag Stojanovic Faculty of Medicine, University of Niš, Niš, Serbia
  • Nikola Stojanovic Faculty of Medicine, University of Niš, Niš, Serbia
  • Zorica Stojanovic-Radic Faculty of Science and Mathematics, University of Niš, Niš, Serbia
  • Valentina Arsić Arsenijević Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Suzana Otasevic Faculty of Medicine, University of Niš, Niš, Serbia
  • Pavle Randjelovic Faculty of Medicine, University of Niš, Niš, Serbia
  • Niko S Radulović Faculty of Science and Mathematics, University of Niš, Višegradska 33, 18000 Niš, Serbia
Keywords: Candida, bloodstream infections, antifungal susceptibility, virulence factors, surveillance

Abstract

Introduction: Candida spp. frequently cause hospital-acquired bloodstream infections (BSI) with a high mortality rate (up to 70%). We analyzed the frequency, infection characteristics, potential predisposing factors, susceptibility to antifungal drugs, biofilm production and other virulence characteristics of Candida spp. isolates obtained from a tertiary care hospital in Niš, Serbia, during a one year period.

Methods: Medical histories, characteristics of isolated strains and drug susceptibility, as well as the effect on the function of isolated macrophages and other virulence features were evaluated. The obtained results were subjected to student’s t-test and multivariate statistical analyzes.

Results: Herein we report an annual incidence of 3.65 cases of C. albicans, C. lusitaniae and C. lipolytica infections per 105 population. Out of eight isolated strains, two (25%) were shown to be strong biofilm producers, one (12.5%) caused hemolysis on blood agar and in two (25%) cases macrophages were able to completely eliminate the yeast colonies. Chronic kidney disease, diabetes, malignant and other diseases were present in 37.5, 62.5, 50 and 75%, respectively, in the study group. All patients with Candida BSI received antifungal therapy (amphotericin B), however, hospital mortality was observed in 25% of patients.

Conclusions: Evaluation of local Candida epidemiology, antifungal susceptibility and virulence factors, as well as personalized patient risk factors are important for the surveillance of Candida BSI, especially in intensive care unit patients and may contribute to the improved options and outcome for patients with Candida BSI.

Published
2016-06-30
How to Cite
1.
Stojanovic P, Stojanovic N, Stojanovic-Radic Z, Arsić Arsenijević V, Otasevic S, Randjelovic P, Radulović NS (2016) Surveillance and characterization of Candida bloodstream infections in a Serbian tertiary care hospital. J Infect Dev Ctries 10:643-656. doi: 10.3855/jidc.7970
Section
Original Articles