Characteristics and clinical outcomes of patients with Candida bloodstream infections in a tertiary care hospital in Jordan

Abstract

Introduction: Candida species are important causes of bloodstream infections, accounting for significant morbidity and mortality in hospitalized patients. Methodology: A retrospective observational study was conducted in an academic tertiary hospital of Jordan. The medical records of patients hospitalized over a ten-year period. were reviewed and patients with candidemia were identified. Data analysis included the infecting Candida species, resistance to antifungals, and risk factors associated with mortality. Results: A total of 158 cases of candidemia were identified, with an overall incidence rate of 0.48 episodes/1,000 admissions. The proportion of candidemia caused by Candida albicans (44.3%) was higher than that of candidemia caused by non-albicans Candida species (42.4%). Exposure to antibiotic therapy before hospitalization was the only independent factor associated with non-albicans Candida infection (OR 2.454; p = 0.033). The overall crude 30-day mortality was 38.7%. Central venous catheterization (OR 0.255; p = 0.026), mechanical ventilation (OR 0.162; p = 0.003), severe sepsis and septic shock (OR = 0.073; p = 0.008), admission to intensive care unit (OR 0.78; p = 0.001), C. albicans (OR 0.235; p = 0.018), length of stay (OR 1.057; p = 0.001), number of comorbidities (OR 0.580; p = 0.008) were independent risk factors for 30-day mortality. Conclusion: This study identified several risk factors associated with blood stream infections caused by Candida over 10-years period. Continuous surveillance programs to monitor such types of infection are of great value to antimicrobial stewardship programs.