Candidaemia in a tertiary hospital in Nigeria

Background: Candidaemia is a widely-studied and reviewed topic in the developed world; however, there is a dearth of information on nosocomial candidaemia in Nigeria, despite the increasing use of more invasive therapeutic modalities, immunosuppressive agents and increasing incidence of immunosuppre...

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Main Authors: Rita O. Oladele, Rashidi A. Bakare, Michael A. Petrou, Oyinlola O. Oduyebo, Malcolm Richardson
Format: Article
Language:English
Published: AOSIS 2014-08-01
Series:African Journal of Laboratory Medicine
Subjects:
Online Access:https://ajlmonline.org/index.php/ajlm/article/view/89
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author Rita O. Oladele
Rashidi A. Bakare
Michael A. Petrou
Oyinlola O. Oduyebo
Malcolm Richardson
author_facet Rita O. Oladele
Rashidi A. Bakare
Michael A. Petrou
Oyinlola O. Oduyebo
Malcolm Richardson
author_sort Rita O. Oladele
collection DOAJ
description Background: Candidaemia is a widely-studied and reviewed topic in the developed world; however, there is a dearth of information on nosocomial candidaemia in Nigeria, despite the increasing use of more invasive therapeutic modalities, immunosuppressive agents and increasing incidence of immunosuppression as a result of malignancies and HIV. Objectives: To determine the hospital-based frequency of candidaemia in a tertiary hospital in Ibadan, Nigeria. Method: This was a prospective descriptive study which included 230 immunosuppressed patients. All isolates were identified to the species level using both conventional and automated methods. Thereafter, all Candida species isolated were tested for antifungal susceptibility using the broth microdilution method. Results: Candidaemia occurred in 12 (5.21%) of the 230 study patients, with C. tropicalis accounting for 50% of the infections. Four patients (33.3%) presented with C. parapsilosis, one (8.3%) with C. albicans and one (8.3%) with a mixed infection of C. albicans and C. tropicalis. All 12 isolates were sensitive to fluconazole (minimal inhibitory concentration < 8 mg/mL). Univariate analysis revealed that old age, multiple surgeries and long-term hospitalisation were significant contributing factors for the occurrence of candidaemia. Eleven (91.7%) of the 12 patients with candidaemia had Candida colonisation of other sterile sites including the bladder, peritoneum and trachea. Furthermore, bivariate analysis revealed that mucositis (p = 0.019) and diarrhoea (p = 0.017) were significantly associated with an increased risk of candidaemia. The crude mortality rate of candidaemia was 91.7%. Conclusion: This study highlights the significance of nosocomial candidaemia and the need for proactive laboratory investigation and clinical management of this life-threatening disease.
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spelling doaj.art-dd1797c3a10641eb88b47adb2ae0e5082022-12-22T02:30:39ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102014-08-0131e1e510.4102/ajlm.v3i1.8942Candidaemia in a tertiary hospital in NigeriaRita O. Oladele0Rashidi A. Bakare1Michael A. Petrou2Oyinlola O. Oduyebo3Malcolm Richardson4Department of Medical Microbiology and Parasitology, University College HospitalDepartment of Medical Microbiology and Parasitology, University College HospitalDepartment of Microbiology, Hammersmith Hospital, Imperial CollegeDepartment of Medical Microbiology, College of Medicine, University of LagosMycology Reference Laboratory, University of ManchesterBackground: Candidaemia is a widely-studied and reviewed topic in the developed world; however, there is a dearth of information on nosocomial candidaemia in Nigeria, despite the increasing use of more invasive therapeutic modalities, immunosuppressive agents and increasing incidence of immunosuppression as a result of malignancies and HIV. Objectives: To determine the hospital-based frequency of candidaemia in a tertiary hospital in Ibadan, Nigeria. Method: This was a prospective descriptive study which included 230 immunosuppressed patients. All isolates were identified to the species level using both conventional and automated methods. Thereafter, all Candida species isolated were tested for antifungal susceptibility using the broth microdilution method. Results: Candidaemia occurred in 12 (5.21%) of the 230 study patients, with C. tropicalis accounting for 50% of the infections. Four patients (33.3%) presented with C. parapsilosis, one (8.3%) with C. albicans and one (8.3%) with a mixed infection of C. albicans and C. tropicalis. All 12 isolates were sensitive to fluconazole (minimal inhibitory concentration < 8 mg/mL). Univariate analysis revealed that old age, multiple surgeries and long-term hospitalisation were significant contributing factors for the occurrence of candidaemia. Eleven (91.7%) of the 12 patients with candidaemia had Candida colonisation of other sterile sites including the bladder, peritoneum and trachea. Furthermore, bivariate analysis revealed that mucositis (p = 0.019) and diarrhoea (p = 0.017) were significantly associated with an increased risk of candidaemia. The crude mortality rate of candidaemia was 91.7%. Conclusion: This study highlights the significance of nosocomial candidaemia and the need for proactive laboratory investigation and clinical management of this life-threatening disease.https://ajlmonline.org/index.php/ajlm/article/view/89candidaemiaIbadanfrequencyhospitalised patients
spellingShingle Rita O. Oladele
Rashidi A. Bakare
Michael A. Petrou
Oyinlola O. Oduyebo
Malcolm Richardson
Candidaemia in a tertiary hospital in Nigeria
African Journal of Laboratory Medicine
candidaemia
Ibadan
frequency
hospitalised patients
title Candidaemia in a tertiary hospital in Nigeria
title_full Candidaemia in a tertiary hospital in Nigeria
title_fullStr Candidaemia in a tertiary hospital in Nigeria
title_full_unstemmed Candidaemia in a tertiary hospital in Nigeria
title_short Candidaemia in a tertiary hospital in Nigeria
title_sort candidaemia in a tertiary hospital in nigeria
topic candidaemia
Ibadan
frequency
hospitalised patients
url https://ajlmonline.org/index.php/ajlm/article/view/89
work_keys_str_mv AT ritaooladele candidaemiainatertiaryhospitalinnigeria
AT rashidiabakare candidaemiainatertiaryhospitalinnigeria
AT michaelapetrou candidaemiainatertiaryhospitalinnigeria
AT oyinlolaooduyebo candidaemiainatertiaryhospitalinnigeria
AT malcolmrichardson candidaemiainatertiaryhospitalinnigeria