Journal of Medical and Surgical Intensive Care Medicine 2018 , Vol 9, Issue 3
Retrospective Evaluation of Non-neutropenic Candidemia Cases in Intensive Care Units
Sema Sarı 1 ,Hayriye Cankar Dal 1 ,İbrahim Mungan 1 ,Büşra Tezcan 1 ,Dilek Kazancı 1 ,Sema Turan 1
1Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Yoğun Bakım Kliniği, Ankara, Türkiye DOI : 10.5152/dcbybd.2018.1799 Objective: Candida species, also found in the normal microbial flora, cause infection by passing natural barriers with chronic diseases and invasive procedures. Although the high risk of candidemia in neutropenic patients is known, it is also common in intensive care units (ICU), and the mortality rate is quite high. In this study, we aimed to retrospectively investigate epidemiological data, risk factors, mortality, distribution of Candida species, and accompanying bacterial infections for candidemia in non-neutropenic patients in ICU.

Material and Methods: In this study, patients who were non-neutropenic and developed candidemia in the ICU of Turkey Advanced Specialty Training and Research Hospital between May 2016 and May 2017 were retrospectively evaluated. Patients who stayed (±7 days) in the same ICU, with an APACHE-II score of ±1, during the same period were included as the control group.

Results: Candidemia was detected in 29 adults within 1 year. In total, 11 of the candidemia cases were females (37.9%) and 18 were males (62.1%); mean patient age was 62.0 years. The most common causative agent was Candida albicans (58.6%). In both groups, the three most common accompanying bacterial infections were Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae. Moreover, 30-day mortality was 51.7%. The mean central venous catheter day, the mean mechanical ventilator day, and the length of hospital stay were longer in the candidemia group (p<0.05). The use of meropenem and teicoplanin was statistically significantly more common in the candidemia group (p<0.05).

Conclusion: In this study, we found that the most common Candida species in non-neutropenic patients was C. Albicans, and the most common risk factor for candidemia was the use of meropenem and teicoplanin. The-refore, we believe further studies are needed to evaluate different groups of antibiotics as risk factors for candidemia. Keywords : Candidemia, sepsis, intensive care units, neutropenia