Background
Methods
Setting and study design
Identification and speciation of Candida isolates
Protocol for antifungal use in our hospital
Definitions
Non-duplicate isolates
Days of therapy (DOT)
Defined daily dose (DDD)
Patient days (PD)
Antifungal consumption
Statistical analysis
Results
Antifungal consumption
Antifungal Class | Hospital Department | ||||||
---|---|---|---|---|---|---|---|
Critical care |
Paediatric
| Hem/Onc | OBGYN | Surgery | IM | P-value | |
Azoles | 48.41 ± 14.58 | 23.29 ± 9.24 | 214.65 ± 47.67 | 0.94 ± 1.10 | 24.31 ± 10.24 | 46.44 ± 9.50 | < 0.0001 |
Echinocandins | 21.13 ± 27.26 | 1.35 ± 1.55 | 67.96 ± 19.04 | 0.42 ± 1.19 | 7.20 ± 11.25 | 7.69 ± 5.49 | < 0.0001 |
Amphotericin B | 4.32 ± 3.62 | 4.06 ± 3.36 | 65.50 ± 18.98 | 0 | 2.06 ± 3.62 | 2.34 ± 1.49 | < 0.0001 |
Total | 73.85 ± 22.25 | 28.70 ± 11.96 | 348.12 ± 85.41 | 1.36 ± 0.47 | 33.56 ± 11.65 | 56.48 ± 24.06 | < 0.0001 |
Antifungal Class | Hospital Department | ||||
---|---|---|---|---|---|
Critical care | Hem/Onc | OBGYN | Surgery | IM | |
Azoles | 33.79 (±10.98) | 146.51 (±41.28) | 0.56 (±1.03) | 22.76 (±9.97) | 39.73 (±7.25) |
Echinocandins | 11.36 (±8.33) | 57.96 (±25.48) | 0 | 4.38 (±8.27) | 7.26 (±6.92) |
Amphotericin B | 4.29 (±4.36) | 79.83 (±30.56) | 0 | 0.50 (±0.98) | 1.93 (±1.60) |
Candida isolates distribution
General distribution of Candida species with a focus on NAC in different departments
Department |
Candida albicans
(N = 1044 isolates) | Non-albicans Candida (N = 333 isolates) | P-value |
---|---|---|---|
Critical care | 313 (76.3%) | 97 (23.7%) | 0.02 |
IM | 498 (73.9%) | 176 (26.1%) | |
OBGYN | 53 (91.4%) | 5 (8.6%) | |
Hem/Onc | 50 (74.6%) | 17 (25.4%) | |
Paediatric | 67 (84.8%) | 12 (15.2%) | |
Surgery | 63 (70.8%) | 26 (29.2%) |
Ward | Total | Total NAC | C. albicans (n = 1044) | C. glabrata (n = 197) | Non-speciated C. (n = 45) | C. famata (n = 30) | C. Kefyr (n = 19) | C. parapsilosis (n = 12) | C. lusitaniae (n = 11) | C. krusei (n = 10) | C. tropicalis (n = 5) | C. guilliermondii (n = 4) |
P
|
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Critical care | 410 | 97 | 313 (76%) | 60 (62%) | 12 (12%) | 12 (12%) | 5 (5%) | 3 (3%) | 1 (1%) | 3 (3%) | 0 | 1 (1%) | 0.005 |
IM | 674 | 176 | 498 (74%) | 106 (60%) | 25 (14%) | 11 (6%) | 11 (6%) | 5 (3%) | 10 (6%) | 4 (2%) | 4 (2%) | 0 | |
OBGYN | 58 | 5 | 53(91%) | 5 (100%) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
Hem/Onc | 67 | 17 | 50 (75%) | 8 (47%) | 1 (6%) | 4 (23%) | 0 | 0 | 0 | 1 (6%) | 1 (6%) | 2 (12%) | |
Pediatrics | 79 | 12 | 67 (85%) | 4 (33%) | 3 (25%) | 1 (8%) | 1 (8%) | 3 (25%) | 0 | 0 | 0 | 0 | |
Surgery | 89 | 26 | 63 (71%) | 14 (54%) | 4 (15%) | 2 (8%) | 2 (8%) | 1 (4%) | 0 | 2 (8%) | 0 | 1 (4%) |
Distribution of different species of NAC
Distribution of Candida glabrata in different departments
Non-albicans Candida |
Candida glabrata
| ||
---|---|---|---|
Total antifungals | Spearman’s coefficient | 0.38 | 0.12 |
p-value | 0.46 | 0.83 | |
Azoles | Spearman’s coefficient | 0.40 | 0.13 |
p-value | 0.43 | 0.80 | |
Echinocandins | Spearman’s coefficient | 0.39 | 0.18 |
p-value | 0.43 | 0.73 | |
Amphotericin B | Spearman’s coefficient | 0.27 | −0.003 |
p-value | 0.59 | 0.99 |