Epidemiological trends in invasive candidiasis: Results from a 15-year study in Sousse region, Tunisia

Abstract

Background: Candida spp. has emerged as one of the most important pathogens causing nosocomial infections, especially in critically ill patients. Objective: The aim of this study was to analyze the trends in incidence and distribution of Candida species causing invasive candidiasis diagnosed in Farhat-Hached teaching hospital in Sousse region (Tunisia). Material and methods: Laboratory data from January 1st, 1995 to December 31st, 2009 were reviewed. Results: A total of 369 Candida strains were isolated in 363 episodes of invasive candidiasis. The isolates were recovered from normally sterile sites (256) and intravascular catheters (107). The number of episodes of invasive candidiasis ranged from 10 to 49 per year with an average of 24 episodes per year. This frequency gradually increased over the 15-year study period. Neonatology accounted for highest number of invasive candidiasis episodes (61.1%). Ten Candida species were isolated and four of them (C. albicans [64.0%], C. parapsilosis [13.3%], C. tropicalis [11.6%] and C. glabrata [5.4%]) accounted for 94.3% of isolates. Our study revealed a mycological shift in the Candida species causing invasive candidiasis with an increase of the non-albicans species mainly C. parapsilosis (P=. 0.0003) and to a lesser extent C. tropicalis and C. glabrata. Conclusion: The invasive candidiasis, in increase in our hospital, is mainly diagnosed in neonatology. A shift in species distribution from a preponderance of C. albicans to more frequent isolation of non-albicans species was observed. © 2011 Elsevier Masson SAS.