Incidence, Species Distribution, and Antifungal Susceptibility of Candida Bloodstream Infections in a Tertiary Algerian Hospital

Introduction/objective: Invasive fungal diseases (IFDs) remain a major cause of morbidity and mortality in the healthcare settings. Candida infections are the most frequent IFDs and are associated with high mortality rates. To date, few studies have been conducted on candidemia in Algeria. The aim of this study was to assess the incidence, species distribution and antifungal susceptibility for Candida bloodstream infections.

Materiels/methods: This prospective, monocentric study covered all episodes of candidemia diagnosed in the intensive care unit at CHU Setif in Algeria over a one-year period. Blood samples were incubated in a BacT/ALERT 480 (bioMérieux, Marcy-l’Étoile, France). Yeasts isolates were identified using MALDI TOF (Bruker Daltonics, Bremen, Germany). Antifungal susceptibility testing for caspofungin, micafungin, anidulafungin, amphorericin B, 5FC, fluconazol, itraconazol, posaconazol and voriconazol was performed using sensititre yeast one (Thermo Fisher Scientific).

Results: During the study period, fourteen episodes of candidemia were recorded. The incidence rate was 7.03 cases per admission in the ICU and 1.15 cases per 1000 patient-days. The mean age of the patients was 30.82 ± 24.87 years (range: 44 days to 81 years) and 57.14% were male. C. albicans was the most common species (42.3%), followed by C. glabrata (21.4%), C.parapsilosis (21.4%), C.tropicalis (7.14%) and C.pelliculosa (7.14%). Overall, 78.6 % of isolates were sensitive to all antifungals. One isolate of C.glabrata was resistant to posaconazole. Resistance to itraconazol was observed in C.tropicalis, C.glabrata, and C.pelliculosa.

Conclusion: C.albicans was the most frequently isolated species in candidemia episodes. Most species were sensitive to antifungals tested.