Predominance of Candida Glabrata among Non-albicans Candida Species in a 16-Year Study of Candidemia at a Tertiary Care Center in Lebanon

Abstract

Candidemia is associated with a high mortality rate, and its incidence is increasing worldwide with a rise in non-<i>albicans</i> candidemia (NAC). Epidemiologic data from Arab countries are scarce and there are no data from Lebanon; Methods: This is a single-center retrospective chart review of patients with candidemia in a tertiary care center in Lebanon from 2004 to 2019. We extracted data on patient characteristics, isolated <i>Candida</i> species antifungal susceptibility, management and outcomes; Results: We included 170 cases of candidemia. NAC was more common than <i>albicans</i> candidemia (64.7% vs. 35.3%). <i>C. glabrata</i> was the most common non-<i>albicans</i> species (37 isolates) followed by <i>C. tropicalis</i> (14). Recent use of antifungals was a risk factor for NAC (OR = 2.8, <i>p</i> = 0.01), while the presence of a central venous catheter was protective (OR = 0.41, <i>p</i> = 0.02). Fluconazole resistance was 12.5% in <i>C. albicans</i> and 21.5% in non-<i>albicans</i> spp. Mortality at 30 days was 55.5%, with no difference between NAC and <i>albicans</i> candidemia. It was higher in older and critically ill patients but lower in patients whose central venous catheter was removed after detecting fungemia; Conclusions: Candidemia is associated with high mortality in Lebanon, with a predominance of NAC and high prevalence of <i>C. glabrata</i>.