Predictors and outcomes of Candida bloodstream infection: eight-year surveillance, western Saudi Arabia

OBJECTIVES: To assess the epidemiological pattern of Candida bloodstream infection (BSI) over an 8-year period (2002-2009) in King Abdulaziz Medical City, western Saudi Arabia. METHOD: A retrospective chart review was performed. RESULTS: A total of 258 BSI were identified in 134 males (53.2%) and 118 females (46.8%). There were 86 (34.1%) cases of Candida albicans and 166 (65.9%) non-albicans Candida species. Malignancy was independently associated with the development of candidemia by non-albicans Candida species (odds ratio 3.24, 95% confidence interval 1.25-8.41). Fluconazole in vitro susceptibility was 38.5% for C. albicans and 52.5% for other Candida species. The overall, crude 12-month mortality rate was 50% for C. albicans and 57.8% for non-albicans Candida species. CONCLUSIONS: The antifungal resistance coinciding with a change in the epidemiologic pattern of candidemia identified in this study is alarming and urges the need for a review of empiric antifungal therapy and potential contributing environmental factors.