Frequency, clinical presentation and microbiological spectrum of candidemiain a tertiary care center in Karachi, Pakistan.

Objective: To document the frequency, clinical presentation, outcome and spectrum of species in Candida blood stream infection.

Methods: A prospective, descriptive cohort study was conducted from June 1st till November 30th 2012 at the Sindh Institute of Urology and Transplantation in Karachi, Pakistan. All patients > or = 15 years of age from nephrology, urology, gastroenterology, oncology or intensive care units with candidemia were included.

Results: Of 2457 positive blood cultures, 145 (6%) were positive for Candida species in 121 patients. Seventy seven patients were included for further analysis as clinical data was available for these. The majority of patients had renal failure (89.6%) and 44% had femoral line. Non- albicans species were isolated in 70 (90.9%) patients; Candida parapsilosis in 28 (36.4%), C. lusitaniae in 23 (29.9%), C. tropicalis in 16 (20.8%), C. glabrata in 3 (3.9%) with only 7 (9.1%) with C. albicans. Mortality was 23.4% (18 patients).

Conclusion: Frequency of candidemia and species distribution with predominantly non-albicans candida in our study is similar to that reported from other developing countries. Mortality is high. The majority of our patients had line related candidemia. Therefore prevention of line infection must be our top priority.