Predictors and outcomes of Candida bloodstream infection: eight-year surveillance, western Saudi Arabia.
OBJECTIVE
To assess the epidemiological pattern of Candida bloodstream infection (BSI) over an 8-year period (2002-2009) in King Abdulaziz Medical City, western Saudi Arabia.


METHODS
A retrospective chart review was performed.


RESULTS
A total of 258 BSI were identified in 134 males (53.2%) and 118 females (46.8%). There were 86 (34.1%) cases of Candida albicans and 166 (65.9%) non-albicans Candida species. Malignancy was independently associated with the development of candidemia by non-albicans Candida species (odds ratio 3.24, 95% confidence interval 1.25-8.41). Fluconazole in vitro susceptibility was 38.5% for C. albicans and 52.5% for other Candida species. The overall, crude 12-month mortality rate was 50% for C. albicans and 57.8% for non-albicans Candida species.


CONCLUSIONS
The antifungal resistance coinciding with a change in the epidemiologic pattern of candidemia identified in this study is alarming and urges the need for a review of empiric antifungal therapy and potential contributing environmental factors.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU- HS), Jeddah, Saudi Arabia; Section of Infectious Diseases, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 9515, 21423 Jeddah, Saudi Arabia. Electronic address: thaqafiao1@ngha.med.sa.
Abdul Hakeem O
AH
Al Thaqafi
College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU- HS), Jeddah, Saudi Arabia; Section of Infectious Diseases, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 9515, 21423 Jeddah, Saudi Arabia; Department of Community Medicine and Public Health, Faculty of Medicine, Menoufia University, Egypt.
Fayssal M
FM
Farahat
Section of Infectious Diseases, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 9515, 21423 Jeddah, Saudi Arabia.
Maher I
MI
Al Harbi
College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU- HS), Jeddah, Saudi Arabia; Division of Microbiology, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia.
Abdul Fattah W
AF
Al Amri
Department of Medicine, Duke University Medical Centre, Durham, North Carolina, USA.
John R
JR
Perfect
D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000472:pathogenicity / Q000502:physiology; D002176:Candida albicans / Q000472:pathogenicity / Q000502:physiology; D058387:Candidemia / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D025141:Drug Resistance, Fungal; D062665:Epidemiological Monitoring; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome
D000935:Antifungal Agents; D015725:Fluconazole
Candidemia; Epidemiology; Saudi Arabia