Epidemological profile, risk factors and predictors of mortality of candidemia patients in tertiary care hospital of north india

Background &objective: Candidemia is a life threatening infection causing high mortality in admitted patients.
Methods: This study was done in the department of Microbiology, DMCH for a period of one year (jan-dec2016) in patients >18yrs admitted in the hospital. Blood culture was taken from the patients clinically suspected with sepsis. Demographic details, risk factors, APACHE II and Candida score were recorded in a predesigned proforma. Patients with blood culture positive for growth of yeast were included. Identification and antifungal susceptibility was done in VITEK 2 System.
Results &Interpretation: A total of 92 patients who had candidemia were studied and the positivity percentage of candidemia was 0.5%. Prevalence was found to be 1.6/1000 admitted patients in the hospital. Among all the isolates obtained, “non-albicans candida” (66.3%) were predominant than Candida albicans (33.7%). Candida tropicalis was (47.8%) predominant among NAC. The antifungal susceptibility profile reveals that the NAC to be more sensitive to antifungals. Maximum sensitivity was observed for echinocandins and amphotericin-b followed by azoles. Patients discharged 38% in satisfactory condition and 62% died.
Conclusion: Candidemia was prevalent in the patients with sepsis. The scoring system i.e APACHE II score and Candida score are good physiological score for predicting the mortality of the patient. The susceptibility pattern shows much higher sensitivity to echinocandins.