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|Year : 2014 | Volume
| Issue : 1 | Page : 88-89
Different epidemiology of candidemia in intensive care unit patients at a hospital in Taiwan
Wei-Lun Liu1, Hsin-Lan Lin2, Chih-Cheng Lai1
1 Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
2 Department of Nursing, Chi Mei Medical Center, Liouying, Tainan, Taiwan
|Date of Web Publication||14-Mar-2014|
Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Liu WL, Lin HL, Lai CC. Different epidemiology of candidemia in intensive care unit patients at a hospital in Taiwan. J Postgrad Med 2014;60:88-9
We read with interest the study of candidemia in intensive care unit (ICU) patients at a tertiary care center in South India.  The authors found that C. tropicalis (n = 29, 74.4%) was the most common pathogen among 39 episodes of candidemia in the ICU, followed by C. albicans (n = 4, 10.3%), C. parapsilosis (n = 3, 7.7%), C. krusei (n = 2, 5.1%) and C. glabrata (n = 1, 2.6%) in a year's investigation. Although this finding is similar to another study from the country, that C. tropicalis causes about 67-90% of candidemia, , C. albicans still remains the most prevalent pathogen in many countries including Taiwan.  The findings could be due to a different setting and the fact that studies in Taiwan did not focus exclusively on ICU patients.
A retrospective study done by us from 2009-2012 analyzed fungal cultures from ICU patients obtained at our hospital at the Chi Mei medical center, Liouying branch. Ours is a 900-bed regional hospital in southern Taiwan. . BACTEC Myco/F Lytic bottles (Becton Dickinson Microbiology Systems, Sparks, MD) containing 5-10 mL of blood were incubated in the BACTEC 9240 culture system at 35 o C. The identification of Candida species was confirmed by using the API 20C and Vitek YBC systems (bioMerieuxVitek, St. Louis, MO).
A total of 126 episodes 126 episodes of candidemia were identified.. Thirteen patients had polycandidal candidemia. Among them, six had concomitant C. albicans and C. glabrata, four had C. albicans and C. parapsilosis, two had C. tropicalis and C. parapsilosis, and one had C. albicans and C. tropicalis. Overall, C. albicans (n = 79, 56.8%) was the most common pathogen, followed by C. tropicalis (n = 24, 17.3%), C. glabrata (n = 19, 13.7%), C. parapsilosis (n = 15, 10.8%), C. guilliermondii (n = 1, .07%) and unidentified Candida species (n = 1, 0.7%). The annual number of each Candida species from 2009 to 2012 is shown in [Figure 1]. The ratio of C. albicans among all episodes of candidemia in each year ranged from 48.7to 62.2%. This study in a Taiwanese ICU showed that C. tropicalis was the second most common pathogen in ICU patients in Taiwan, followed by C. albicans, and that C. albicans comprised about half of the candidemia in ICU patients. Our finding is thus different from Giri et al. study in India suggesting that each ICU should regularly conduct the surveillance study to establish its own epidemiology and thus management policies.
|Figure 1: Annual number of each candida species causing candidemia among intensive care unit patients from 2009 to 2012|
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| :: References|| |
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|3.||Sahni V, Agarwal SK, Singh NP, Anuradha S, Sikdar S, Wadhwa A, et al. Candidemia-an under-recognized nosocomial infection in Indian hospitals. J Assoc Physicians India 2005;53:607-11. |
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