Abstract

Research Article

Predictors of Candidemia infections and its associated risk of mortality among adult and pediatric cancer patients: A retrospective study in Lahore, Punjab, Pakistan

Hafiz Muhammad Bilal*, Neelam Iqbal and Shazia Ayaz

Published: 18 May, 2018 | Volume 2 - Issue 1 | Pages: 001-007

Objectives: As the cancer patients are at higher risk of premature deaths due to candidemia. So, the present study aims to evaluate the predictors of candidemia along with its outcomes among hospitalized adults and pediatric cancer patients.

Methods: A retrospective study was conducted at a tertiary care cancer hospital in Lahore, Pakistan. The data was collected from the medical records of all the patients who were found positive for Candida species between 1st January 2017 and 31st June 2017. Data were analyzed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) and Microsoft Excel (MS Office 2010).

Results: Overall, 135 patients were detected with candidemia. Based on blood culture test results, it was found that out of 100 cultures positive for any microorganism there were 2 cases of candidemia. Multivariate analysis revealed that hematological malignancies (AOR: 2.1), and shock (AOR: 9.1) were significantly associated with high risk of mortalities during the index hospitalization, while risk of mortality among cancer patients suffering from Candida albican infection (AOR: 0.47) and those who were administered with antifungal agent after sensitivity report of the fungal culture (AOR: 0.2) was significantly less. Also, there was no significant association of empiric therapy of antifungal agent with the risk of mortality before a positive culture found (p>0.05).

Conclusion: Although, no risk factor was found to be associated significantly with candidemia among cancer patients. But hematological malignancies, non-albican candidemia and shock were predictors of higher risk mortality during index hospitalization.

Read Full Article HTML DOI: 10.29328/journal.acst.1001003 Cite this Article Read Full Article PDF

Keywords:

Cancer patients; Hematological malignancies; Predictors; Albican; Non-albican; Candidemia

References

  1. Tang HJ, Liu WL, Lin HL, Lai CC. Epidemiology and prognostic factors of candidemia in cancer patients. PLoS One. 2014; 9: e99103. Ref.: https://goo.gl/AdcpHR
  2. Falagas M, Apostolou K, Pappas V. Attributable mortality of candidemia: a systematic review of matched cohort and case-control studies. Eur J Clin Microbiol Infect Dis. 2006; 25: 419-425. Ref.: https://goo.gl/7ijwXo
  3. Gudlaugsson O, Gillespie S, Lee K, Vande Berg J, Hu J, et al. Attributable mortality of nosocomial candidemia, revisited. Clin Infect Dis. 2003; 37: 1172-1177. Ref.: https://goo.gl/yHhQJY
  4. Taur Y, Cohen N, Dubnow S, Paskovaty A, Seo SK. Effect of antifungal therapy timing on mortality in cancer patients with candidemia. Antimicrob Agents Chemother. 2010; 54: 184-190. Ref.: https://goo.gl/kBcQ7W
  5. Hachem R, Hanna H, Dimitrios K, Ying Jiang, Issam Raad. The changing epidemiology of invasive candidiasis. Cancer. 2008; 112: 2493-2499. Ref.: https://goo.gl/ZTR2xH
  6. Garey KW, Rege M, Pai MP, Mingo DE, Suda KJ, et al. Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis. 2006; 43: 25-31. Ref.: https://goo.gl/3rtvzV
  7. Centre SKMCHR. Facts and Statistics. 2016.
  8. Siddiqui NU, Wali R, Haque AU, Fadoo Z. Healthcare-associated infections among pediatric oncology patients in Pakistan: risk factors and outcome. J Infect Dev Ctries. 2011; 6: 416-421. Ref.: https://goo.gl/W6mXA3
  9. Ariff S, Saleem AF, Soofi SB, Sajjad R. Clinical spectrum and outcomes of neonatal candidiasis in a tertiary care hospital in Karachi, Pakistan. J Infect Dev Ctries. 2011; 5: 216-223. Ref.: https://goo.gl/BG3N9A
  10. Bhatti MA, Karmarkar R, Wagner DK. Candida albicans myocardial abscess. J Coll Physicians Surg Pak. 2003; 13: 456-458. Ref.: https://goo.gl/E8ix3C
  11. Kumar S, Kalam K, Ali S, Siddiqi S, Baqi S. Frequency, clinical presentation and microbiological spectrum of candidemia in a tertiary care center in Karachi, Pakistan. J Pak Med Assoc. 2014; 64: 281-285. Ref.: https://goo.gl/e16hB9
  12. Ullah K, Ahmed P, Raza S, Satti T, Nisa Q, et al. Allogeneic stem cell transplantation in hematological disorders: single center experience from Pakistan. Transplant Proc. 2007; 39: 3347-3357. Ref.: https://goo.gl/kuBZcn
  13. Sabino R, Veríssimo C, Brandão J, Alves C, Parada H, et al. Epidemiology of candidemia in oncology patients: a 6-year survey in a Portuguese central hospital. Med Mycol. 2010; 48: 346-354. Ref.: https://goo.gl/XJ9Qv5
  14. Ma CF, Li FQ, Shi LN, Hu YA, Wang Y, et al. Surveillance study of species distribution, antifungal susceptibility and mortality of nosocomial candidemia in a tertiary care hospital in China. BMC Infect Dis. 2013; 13: 337. Ref.: https://goo.gl/74mkUh
  15. Chai LY, Denning DW, Warn P. Candida tropicalis in human disease. Crit Rev Microbiol. 2010; 36: 282-298. Ref.: https://goo.gl/NuXn3K
  16. Pfaller MA, Andes DR, Diekema DJ, Horn DL, Reboli AC, et al. Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004–2008. PLoS One. 2014; 9: e101510. Ref.: https://goo.gl/1zUFVy
  17. Bassetti M, Merelli M, Righi E, Diaz-Martin A, Rosello EM, et al. Epidemiology, species distribution, antifungal susceptibility, and outcome of candidemia across five sites in Italy and Spain. J Clin Microbiol. 2013; 51: 4167-4172. Ref.: https://goo.gl/RLLsEo

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?