Candidaemia in Immune-Compromised Hosts: Incidence and Drugs SusceptibilityMaria T. Mascellino*, Giammarco Raponi, Alessandra Oliva, Claudio M. Mastroianni and Vincenzo Vullo
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
- *Corresponding Author:
- Maria Teresa Mascellino
Department of Public Health and Infectious Diseases
Sapienza University of Rome, Italy
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Received date: September 21, 2012; Accepted date: October 17, 2012; Published date: October 20, 2012
Citation: Mascellino MT, Raponi G, Oliva A, Mastroianni CM, Vullo V (2012) Candidaemia in Immune-Compromised Hosts: Incidence and Drugs Susceptibility. J Clin Exp Pathol 2:131. doi:10.4172/2161-0681.1000131
Copyright: © 2012 Mascellino MT, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
We analyzed the different Candidae species isolated from bloodstream infections and the related antifungal susceptibility pattern over a five-year period (2007-2011) at Policlinico Umberto I of Rome (Italy).
The overall incidence of candidaemia during this range of time accounted for 6.4% with a marked increase from 2007 to 2011 (from 3.83% to 9%). The species isolated were the following: C. albicans (42%) and non-albicans (58%). In the period 2007-2009, C.krusei was the most frequent species detected among non-albicans species (29.4%), followed by C.glabrata (20%), whereas during 2010-2011 we found a shift versus C. parapsilosis increasing from 4.6% to 33%.
C.albicans showed a good susceptibility to the most antifungal agents. C. krusei exhibited a raising resistance to flucytosin and fluconazole. As for fluconazole, it shows an intrinsic resistance. In C. glabrata we observed increased resistance especially to fluconazole for which this species shows a Susceptibility Dose-Dependent (SDD). C.tropicalis had only a resistance to fluconazole (MIC 90%=16 mcg/ml) In vitro activity of the echinocandins resulted to be very strong for all Candidae species. These drugs have a fungicidal activity and their use is recommended in the most severe diseases.
Our study confirms the high incidence of candidaemia in the setting of critically ill patients. A strong association of Candidae infection with the presence of Central Venous Catheter (CVC) has been markedly noticed especially in the years 2009 and 2011 due to a greater use of CVC in our patients. The overall rate of resistance increased over the study period in all Candidae strains.