Maria Teresa Mascellino
Sapienza University of Rome, Italy
Title: Candida bloodstream infections: species distribution and antifungal susceptibility in intensive care units (ICU) and in non-ICU wards at a University Hospital in Rome (Italy).
Biography
Biography: Maria Teresa Mascellino
Abstract
The incidence of candidaemia varies in different geographical areas and the knowledge of the local data is crucial for an adequate therapeutic approach. Purpose of this study was to analyse the Candida species distribution and the susceptibility profiles to the major antimycotic agents both in ICU (Intensive Care Units) and in non-ICU wards in a tertiary care academic hospital over a 3-year period (2013-2015). 173 patients (averaging 15-78 years) with nosocomial candidaemia were examined. A steady rise in the number of yeasts isolated from bloodstream infections (BSI) was observed in ICU during 2015 as compared with 2013 (16.7% versus 40.9%, p=0.002). Candida albicans was the most detected species (44%) whereas non-albicans strains altogether accounted for 56% being Candida parapsilosis the most frequent isolate (32%). C. tropicalis was significantly higher in non-ICU patients whereas the opposite was true for C. parapsilosis. C. albicans showed a greater isolation rate in ICU (58%) . All the strains tested were fully susceptible to echinocandins and amphotericin B. Decreased susceptibility to fluconazole was seen with C. glabrata and C. parapsilosis. Caspofungin and voriconazole resulted to be the most potent antimycotics especially caspofungin for C. parapsilosis. Incidence of candidaemia per 10,000 admissions ranged from 6.8 to 12.4 over a 3- year period. Fluconazole non-susceptible species became more prevalent especially in non-ICU perhaps due to the wider use of fluconazole in these locations whereas a higher MICs increase for echinocandins was found in ICU probably because of the predominant prescription of these antimycotics in high risk wards.