Candidemia in intensive care unit: epidemiology and prognostic factors

Background: Candidemia, recognized as a fairly common disease in intensive care unit (ICU) patients, is of poor prognosis. Our study aimed to study the epidemiology of a series of candidemia and the factors favoring their aggravation in the intensive care unit (USI) of the Military Hospital of Tunis. Methodology: It is a retrospective study carried out in the laboratory of Parasitology-Mycology and the UCI of the Military Hospital of Tunis over six years. Blood cultures were performed in the MYCOSIS-IC/F® Becton Medium from Deckinson. The identification of the species was made by the chlamydosporulation test and the YST Vitek®2 card. These data were analyzed by SPSS version 22 software. Results: Of 3298 ICU admissions, 58 presented with candidemia resulting in an attack rate of 1.7%, or 17.5 episodes of candidemia per 1000 admissions. The average annual incidence was 9.6 cases/year. The mean age of the patients was 55 ± 15.9 years. We noted a male predominance in 59% of cases with a sex ratio of 1.4. The study of the pathological antecedents showed that these patients were followed mainly for pancreatitis (98.3%), diabetes (37.9%), and arterial hypertension (34.5%). The predominantly isolated species was C. albicans (48.33%). Multivariate analysis revealed that isolation of Candida albicans from blood cultures and arterial hypertension are significant factors of high mortality. Conclusion: This study allowed us to observe epidemiology and prognostic factors of candidemia in a Tunisian series. It can help resuscitators by allowing an optimization of the recommendations for the treatment of candidemia according to the prognostic factors.