Clinical Characteristics and Risk Factors of Candidemia in Tertiary Care Hospital

Introduction: During the past two decades, the incidence of candidemia has doubled and Candida spp. currently ranks in top blood stream pathogen in developed countries. Given the need to ensure appropriate and timely antifungal therapy, there is need to identify these patients as early as possible and therefore a risk stratification for candidemia is imperative. We aim to identify the risk factors of candidemia in patients admitted at our tertiary care center. Methods: A retrospective case control study were conducted on adult patients (15 years. or more) admitted to Aga Khan University Hospital between 2009 and 2013 who developed candidemia (cases)or bacteremia (controls) after 48 hours of admission. Results: A total of 300 patients were enrolled in study (150 cases i.e. candidemia and 150 control i.e. bacteremia). The gender frequency was identical for cases (n=56, 65% males) and controls (n= 55,64 % males). Mean age in year was also similar for cases (56± 17) and controls (55± 18, p = 0.5). Non albican candida spp. are predominantly isolated from blood cultures as compared to Candida albican. Patients who had invasive devices like central lines, urinary catheter, endotracheal tube, nasogastric tube especially central lines (Odd ratio 1.72, CI: 0.98-3.02) and patients who had candida colonization (OR8.50, C.I: 3.76-19.23) were more likely to have candidemia than bacteremia. Conclusion: Risk factors for candidemia include, the presence of invasive devices especially central lines and isolation of candida from other body sites were most predictive of candidemia. These results can be used to help identify patients most likely to benefit from empiric antifungal therapy