Summary auto-generated
This retrospective study examined yeast bloodstream infections at a Hungarian university hospital from 1996 to 2000, analyzing 145 fungemia episodes in 68 patients. Candida albicans was the predominant causative organism, accounting for 73.5% of infections, followed by C. parapsilosis (7.3%), C. krusei (5.9%), C. tropicalis (4.4%), C. glabrata (3%), and Cryptococcus neoformans (3%). Most infections originated from surgical wards (39.3%) and intensive care units (42.1% combined). Species distribution remained consistent throughout the study period. Antifungal susceptibility testing using the Etest method showed all isolates were susceptible to amphotericin B. However, resistance to azole antifungals was notable: 15.7% of isolates showed decreased susceptibility or resistance to fluconazole, while 24% exhibited reduced susceptibility or resistance to itraconazole. In 42 of 68 patients, the same yeast species was isolated from non-blood sources within one week, particularly from urogenital, respiratory, and catheter sites, suggesting these locations as potential sources of bloodstream infection. The overall candidemia rate was 2-4.1 per 10,000 admissions.
Key findings
- C. albicans was the predominant cause of yeast bloodstream infections (73.5%), with stable species distribution over the 5-year period
- All tested yeast isolates were susceptible to amphotericin B, but 15.7% showed resistance to fluconazole and 24% to itraconazole
- Surgical wards and ICUs were the primary sources of yeast bloodstream infections, accounting for over 67% of cases
- In 61.8% of candidemic patients, the same yeast species colonized multiple body sites including urogenital tract, respiratory tract, and central venous catheters within one week of blood culture positivity
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Abstract
The purpose of this study was to evaluate the aetiology and susceptibility of different Candida species originating from blood cultures received from different clinical wards of the University Hospital in Szeged, Hungary, from 1996 to 2000. A total of 145 episodes of fungaemia occurred in 68 patients. In 73.5% of the patients the infections were due to Candida albicans, 7.3% to C. parapsilosis, 5.9% to C. krusei, 4.4% to C. tropicalis and 3% each to C. glabrata, other Candida spp. and Cryptococcus neoformans. There were no appreciable differences in the distribution of yeast species during the 5-year period: C. albicans remained the predominant species causing bloodstream infections in this hospital, similar to the results of other studies (Norway, SENTRY Program in USA, Canada and South America). Most of the Candida isolates (39.3%) were from blood cultures of patients hospitalised in surgical wards, 28.3% were from adult intensive care units (ICUs), 13.8% from paediatric ICUs, 11% from haematology and 7.6% from cardiology departments. MICs for amphotericin B, fluconazole and itraconazole were determined for 83% of the isolates. All isolates were susceptible to amphotericin B. The percentage of yeast isolates with decreased susceptibility or resistance to fluconazole was smaller (15.7%) than that for itraconazole (24%).