Candida bloodstream infections in Serbia: First multicentre report of a national prospective observational survey in intensive care units. Issue 2 (28th September 2017)

• Record Type: Journal Article
• Authors: Arsić Arsenijević, Valentina; Otašević, Suzana; Janić, Dragana; Minić, Predrag; Matijašević, Jovan; Medić, Deana; Savić, Ivanka; Delić, Snežana; Nestorović Laban, Suzana; Vasiljević, Zorica; Hadnadjev, Mirjana
• Is Part Of: Mycoses. Volume 61:Issue 2(2018)
• Page Start: 70
• Page End: 78
• Publication Date: 2017-09-28
• Subjects: Candida bloodstream infections -- epidemiology -- intensive care unit -- outcome -- Serbia; Pathogenic fungi -- Periodicals; Medical mycology -- Periodicals; 616.969
• DOI: 10.1111/myc.12700
• Languages: English
• ISSNs: 0933-7407

Abstract

Summary: Candida bloodstream infections (BSI) are a significant cause of mortality in intensive care units (ICU), hereof the prospective 12‐months (2014‐2015) hospital‐ and laboratory‐based survey was performed at the Serbian National Reference Medical Mycology Laboratory (NRMML). Candida identification was done by a matrix‐assisted laser desorption/ionisation time‐of‐flight mass spectrometry and a susceptibility test, according to the Clinical and Laboratory Standards Institute methodology. Among nine centres (265 beds; 10 820 patient admissions), four neonatal/paediatric (NICU/PICUs) and five adult centres (ICUs) participated, representing 89 beds and 3446 patient admissions, 166 beds and 7347 patient admissions respectively. The NRMML received 43 isolates, 17 from NICU/PICUs and 26 from adult ICUs. C. albicans dominated highly in NICU/PICUs (~71%), whereas C. albicans and C. parapsilosis were equally distributed within adults (46%, each), both accounting for ~90% of received isolates. The resistance to itraconazole and flucytosine were 25% and 2.4% respectively. In addition, the 2 C . albicans were azole cross‐resistant (4.6%). The overall incidence of Candida BSI was ~3.97 cases/1000 patient admissions (4.93 in NICU/PICU and 3.53 in adult ICU). The 30‐day mortality was ~37%, most associated with C. tropicalis and C. glabrata BSI. Data from this national survey may contribute to improving the Balkan and Mediterranean region epidemiology of Candida BSI within ICUs.