Timm athens candidaemia 2009

Timm athens candidaemia 2009

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  Prevalence of Candidaemiain University College Hospital Ibadan Oladele Petrou RO1, & Bakare MA 2 R 1 1Department of Medical Microbiology & Parasitology, University College Hospital, Ibadan, Nigeria; 2Department of Medical Mycology, Imperial Healthcare NHS Trust, London, United Kingdom P095 Introduction Candidaemia is a widely studied and reviewed in the developed world, however there is lack of information on nosocomial candidaemia in Nigeria despite the increasing 10min use of more therapeutic modalities in patient management 48h and the increasing incidence of immunosuppression due to HIV/AIDS, neoplastic disease and use of immunosuppressive agents. The objective of this study was to determine the prevalence of candidaemia, estimate the mortality rates and identify factors associated with 1-2h candidaemia amongst immunosuppressed patients with persistent fever admitted in University College Hospital, Ibadan 10min 48h Hypotonic treatment Materials & Methods Venous blood was collected following standard protocols from 230 immunosuppressed patients with persistent fever while receiving adequate antibacterial coverage and incubated at 37oC using BACTEC 9050. Positive samples were examined microscopically using direct gram staining; those showing yeasts were cultured onto Sabourauds agar and CHROMagar Candida. Germ tube was 24-48h performed on all yeasts for the presumptive identification of C. albicans and all isolates were identified to species level using API20AUX and API32C. The susceptibility of all isolates to Amphotericin B, Flucytosine, Fluconazole, Itraconazole, Voriconazole, Posaconazole and Caspofungin was performed by both the CLSI and EUCAST method. Clinical details of the 24-48h patients were entered into a semi-structured pro-forma form incorporating socio-demographic data, medical/surgical history of 48h known risk factors for Candidaemia and other laboratory findings for Candida and analysed using SPSS 13.0 software. Results Candidaemia, the 3rd most common isolate recovered from blood was detected in twelve patients, a prevalence of 5.2%. Time to Conclusion: positive culture was 1 to 7 (mean 3.5) days. The species isolated were These findings prove that Candidaemia may be the C. parapsilosis 4 (33.3%); C. tropicalis 6 (50.0%); C. albicans 1 (8.3%); and mixed infection of C. albicans and C. tropicalis 1 (8.3%). cause of persistent fever in immunosuppressed patients CHROMagar Candida failed to identify all the species whereas both that are not on prophylaxis or empiric antifungal API20AUX and API32C gave the same result. The susceptibility therapy. The high mortality rate which must be directly data were similar between the two methods and in accordance to related to the delay in commencing treatment should published data for each drug and species. facilitate development of rational approaches for Multivariate analysis using logistic regression and correlation revealed that apart from blood and stool Candida spp isolated from prevention, early identification and appropriate intravenous cut down (P=0.040), mucositis (P=0.019) and diarrhoea management of those patients at risk of developing this (P=0.017) were significantly associated with increased risk of life-threatening condition. Furthermore it highlights development of Candidaemia, while univariate analysis showed that the importance of prompt antifungal treatment and the old age, multiple surgeries and long term hospitalisation were availability of new oral and intravenous drug in significant contributing factors. There was 91.7% crude (11/12 patients) and 50% attributable mortality. hospital pharmacies, as at present our patients can only 4 th Trends in Medical with oral Fluconazole as no other drug is be treated Mycology (TIMM) Hotel Hilton, Athens, Greece, 18th – 21st October 2009 available, and the need for further studies in these susceptible populations.