Evaluation of Species Distribution, Antifungal Susceptibility, and Mortality in Candidemia Cases

Öz

Objective: This study aimed to evaluate the distribution of Candida species, antifungal susceptibility profiles, and 30-day mortality rates in candidemia cases identified in our hospital over a one-year period. Materials and Methods: A total of 98 candidemia cases with Candida species isolated from blood cultures between 01 April 2024 and 30 April 2025 were retrospectively analyzed. Species identification and antifungal susceptibility testing were performed using the Vitek 2 Compact automated system. Demographic characteristics, Candida species distribution, antifungal resistance rates, and 30-day mortality were assessed. Results: Of the 98 candidemia cases, 59.1% were male and 40.9% were female, with a mean age of 73.95±11.40 years. The majority of cases (87.8%) originated from intensive care units. Among the isolates, C. albicans was the most frequently detected species (54.1%). Among non-albicans species, the most common were C. tropicalis (18.4%), C. parapsilosis (13.3%), C. glabrata (9.2%), followed by C. auris (2.0%), C. guilliermondii (2.0%), and C. dubliniensis (1.0%). Antifungal susceptibility testing revealed resistance rates of 1% for amphotericin B, 4.7% for fluconazole, and 3.5% for voriconazole. Resistance to echinocandins was detected in 4.2% of isolates. The 30-day mortality rate was 63.3% (62/98). There was no statistically significant difference in mortality among Candida species (p=0.25). The mean age of patients who died (76.4±10.46) was significantly higher than that of survivors (69.66±11.81) (p=0.006). Although mortality was higher in males compared to females, the difference was not statistically significant (p=0.23). Conclusion: Comprehensive evaluation of species distribution, antifungal resistance patterns, and mortality outcomes is essential for improving patient management and guiding effective treatment strategies in candidemia.

Anahtar Kelimeler

• Candidemia
• Invasive candidiasis
• Antifungal susceptibility
• Candida

Kandidemi Olgularında Tür Dağılımı, Antifungal Duyarlılık ve Mortalitenin Değerlendirilmesi

Öz

Amaç: Bu çalışmada, bir yıllık dönemde hastanemizde saptanan kandidemi olgularında Candida türlerinin dağılımının, antifungal duyarlılık profillerinin ve 30 günlük mortalite oranlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: 01.04.2024–30.04.2025 tarihleri arasında kan kültürlerinde Candida türü izole edilen 98 kandidemi olgusu retrospektif olarak incelendi. Tür tanımlaması ve antifungal duyarlılık testleri Vitek 2 Compact otomatize sistemi ile gerçekleştirildi. Hastaların demografik verileri, Candida tür dağılımı, antifungal direnç oranları ve 30 günlük mortalite değerlendirildi. Bulgular:Toplam 98 kandidemi olgusunun %59,1’i erkek, %40,9’u kadın olup hastaların yaş ortalaması 73,95±11,40 yıl idi. Olguların büyük çoğunluğu (%87,8) yoğun bakım ünitelerinde takip edilen hastalardan oluşmaktaydı. Candida türlerinin dağılımında C. albicans %54,1 ile en sık izole edilen etkendi.Non-albicans türler arasında en sık C. tropicalis (%18,4), ardından C. parapsilosis (%13,3), C. glabrata (%9,2), C. auris (%2,0), C. guilliermondii (%2,0) ve C. dubliniensis (%1,0) saptandı. Antifungal duyarlılık sonuçlarında Amfoterisin B direnci %1, flukonazol direnci %4,7 ve vorikonazol direnci %3,5 olarak belirlendi. Ekinokandin grubu ajanlara direnç oranı %4,2 olarak bulundu. Olguların 30 günlük mortalite oranı %63,3 (62/98) idi. Türlere göre mortalite incelendiğinde, türler arasında istatistiksel olarak anlamlı bir fark saptanmadı (p=0,25). Mortalite gelişen hastaların yaş ortalaması (76,4±10,46), sağ kalanlara (69,66±11,81) göre anlamlı derecede yüksekti (p=0,006). Erkeklerde mortalite kadınlara göre daha yüksek bulunmakla birlikte fark istatistiksel olarak anlamlı değildi ( p=0,23). Sonuç: Tür dağılımı, antifungal direnç ve mortalite verilerinin kapsamlı değerlendirilmesi, kandidemi yönetiminde hasta sonuçlarını iyileştirmek ve tedavi stratejilerini geliştirmek için önemlidir.

Anahtar Kelimeler

• Kandidemi
• İnvaziv kandidiyazis
• Antifungal duyarlılık
• Candida

Kaynakça

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