Candidemia in a burn intensive care unit, a six-year analysis

ABSTRACT

To determine the current candidemia frequency trends in Burn Intensive Care Unit [BICU], to assess the dominant species causing infection and the mortality rates among burn patients. The populationstudied [six-year retrospective study from January 2000 to January 2006] comprised all the patients with microbiological evidence of septicaemia admitted to the BICU at the Burn and Plastic Surgery Hospital [BPSH], Tripoli, Libya. Candida species isolated from blood culture were identified using API-20 C AUX system. Among 691 admitted to BICU, there were 24 [6.3%] episodes of candidemia identified from 380 positive blood cultures. There was a difference in the yearly episodes observed during this period with higher numbers of cases in the years 2000 and 2002. Candida ranked the fourth most common isolate exceeded only by Staphylococci, Pseudomonas, and Klebsiella. Five patients [20.8%] had only Candida species, while the majority [79.2%] had a multiple episodes caused by one or two bacterial species followed by Candida. C. albicans was the most frequently isolated species accounting for 58% of all isolates. Non-albicans Candida species accounted for 42% of all episodes of candidemia and were mostly represented by C. parasilosis 5 [20.8%], C. glabrata 4 [16.6%[and C. tropicalis 2 [8.3%] Despite that all patients received fluconazole, the overall mortality rate 14/24 [58%] was significantly high [P <0.05] compared with 85/187 [45%] patients who had septicemia but from whom Candida species were not isolated. Blood stream infections [BSls] caused by Candida species were the 4[th] most common isolate exceeded only by Staphylococci, Pseudomonas, and Klebsiella. We suggest that surveillance for antifungal sensitivities should be conducted for successful treatment