Microbiological and epidemiological characteristics of candidiasis in outpatient population of Split-Dalmatia County from 2012 to 2021

Cilj istraživanja: Cilj ovog istraživanja je prikazati mikrobiološke i epidemiološke značajke kandidoza u vanbolničkoj populaciji Splitsko-dalmatinske županije u periodu od 10 godina (2012. – 2021.). Materijali i metode: Provedeno je retrospektivno istraživanje u kojem su korišteni podatci iz arhive Nastavnog Zavoda za javno zdravstvo Splitsko-dalmatinske županije u desetogodišnjem periodu od 1. siječnja 2012. do 31. prosinca 2021. godine. Analizirani su podatci o vrsti izoliranih gljiva, dobi i spolu bolesnika, vrsti uzorka te datumu uzimanja uzorka. Rezultati: U promatranom razdoblju izolirano je ukupno 9083 izolata gljiva roda Candida, najčešće iz obrisaka usne šupljine (33,06%) i jezika (21,94%) te uzoraka stolice (16,59%). Najčešće izolirana vrsta je C. albicans (70,1%), a naučestalija non-albicans vrsta bila je C. glabrata (13,23%). Slijede C. parapsilosis (4,1%), C. krusei (2,84%) i C. tropicalis (2,09%). Ostale vrste kandida izolirane su u manje od 1% slučajeva. Infekcija Candidom, neovisno o vrsti, učestalija je kod ženskog spola (74,52%). Vrste C. glabrata, C. tropicalis i C. kefyr češće su izolirane u osoba ženskog, a C. lusitaniae, C. famata i C. parapsilosis učestalije su među osobama muškog spola. Srednja životna dob bolesnika kod kojih su izolirane non-albicans vrste je 4 godine veća u odnosu na dob bolesnika kod kojih je izolirana C. albicans. U promatranom periodu utvrđen je statistički značajan porast broja izolata vrste C. parapsilosis, a pad C. famata i udjela do nivoa vrste neidentificiranih izolata. Pojavnost kandida neovisno o vrsti veća je na jesen. Zaključci: Rezultati utvrđeni ovim istraživanjem u skladu s podatcima iz svjetske literature pokazuju da je C. albicans još uvijek vodeći uzročnik kandidoza. Zabrinjava učestalost nonalbicans vrsta koje su otpornije na antifungike. C. glabrata i C. krusei drugi su i četvrti po učestalosti izolati kandida u vanbolničkoj populaciji. Utvrđen je statistički značajan porast broja izolata C. parapsilosis. Važno je daljnje praćenje lokalne epidemiološke situacije uzročnika kandidoza.Objectives: The aim of this study is to present microbiological and epidemiological characteristics of candidiasis in outpatient population of Split-Dalmatia County during a period of 10 years (2012. – 2021.). Materials and methods: This retrospective study was conducted using data from the archives of the Public Health Institute of Split-Dalmatia County in the ten-year period from 1. 1. 2012. to 31. 12. 2021. The data on the type of isolated fungi, patients age and gender, type of sample, as well as the date of sample collection were analyzed. Results: In the observed period a total of 9083 Candida isolates were isolated at the Public Health Institute of Split-Dalmatia County, most often from oral swabs (33.06%), tongue swabs (21.94%) and stool samples (16.59%). C. albicans was the most common isolate (70.1%), while the most frequently isolated non-albicans species was C. glabrata (13.23%), followed by C. parapsilosis (4.1%), C. krusei (2.84%) and C. tropicalis (2.09%). Other Candida species were isolated in less than 1% of cases. Candida infection, regardless of the species, is more common in women (74.52%). C. glabrata, C. tropicalis and C. kefyr were more often isolated in females, while C. lusitaniae, C. famata and C. parapsilosis were more common among males. The median age of patients in whom non-albicans species were isolated was 4 years higher than the age of patients in whom C. albicans was isolated. In the observed period, there was a statistically significant increase in the number of C. parapsilosis isolates, while a decrease in the number of C. famata and unidentified isolates was observed. The occurrence of Candida, regardless of the species, is higher in autumn. Conclusions: The results presented in this study, according to the data from the world literature, show that C. albicans is still the leading causative agent of candidiasis. The frequency of nonalbicans species which are more resistant to antifungals is of great concern. C. glabrata and C. krusei are the second and fourth most frequent Candida isolates in the outpatient population. A statistically significant increase in the number of C. parapsilosis isolates was found. Further monitoring of the local epidemiological situation regarding the causative agents of candidiasis is important