title: Surveillance and characterization of Candida bloodstream infections in a Serbian tertiary care hospital.
abstract: BACKGROUND
  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.
authors.affiliation: Faculty of Medicine, University of Niš, Niš, Serbia. pedjamicro@orion.rs.
authors.forename: Predrag
authors.initials: P
authors.lastname: Stojanovic
authors.forename: Nikola
authors.initials: N
authors.lastname: Stojanovic
authors.forename: Zorica
authors.initials: Z
authors.lastname: Stojanovic-Radic
authors.forename: Valentina
authors.initials: V
authors.lastname: Arsić Arsenijević
authors.forename: Suzana
authors.initials: S
authors.lastname: Otasevic
authors.forename: Pavle
authors.initials: P
authors.lastname: Randjelovic
authors.forename: Niko S
authors.initials: NS
authors.lastname: Radulović
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D018441:Biofilms / Q000254:growth & development; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity / Q000502:physiology*; D058387:Candidemia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008264:Macrophages / Q000276:immunology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D016019:Survival Analysis; D062606:Tertiary Care Centers; D037521:Virulence Factors / Q000032:analysis / Q000235:genetics; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D037521:Virulence Factors