A five-year retrospective descriptive study on the clinical characteristics and outcomes of candidaemia at a tertiary hospital in South Africa

OBJECTIVES: To describe the clinical features, microbiological profiles and outcome of patients with candidaemia at a tertiary hospital in South Africa. METHODS: A retrospective study of blood cultures isolating Candida species at Tygerberg Hospital from 2014 to 2019. RESULTS: We identified 108 patients with candidaemia. The most frequent species cultured were Candida albicans (51; 47.2%) followed by C glabrata (32; 29.6%), C parapsilosis (11; 10.2%), then C tropicalis (5; 4.6%). No treatment was given in 31 patients (28.7%), of whom 22 (71%) demised. Few patients were screened for complications. Of 14 screened by ophthalmoscopy, none had complications of ophthalmitis, 1 of 23 who underwent echocardiography had infective endocarditis, and 1 of 3 screened had hepatosplenic abscess. Case fatality rate was 59 of 108 (55%). Multivariable logistic regression for predictors of mortality showed that patients with diabetes mellitus were twice as likely to die from candidaemia (odds ratio (OR) 2.43; P=0.079). Failure to consult with Infectious Diseases increased the likelihood of mortality 3 times (OR 2.99; P=0.041). CONCLUSIONS: The all-cause mortality of patients with candidaemia was high. Many patients did not have follow up on blood cultures performed, were not screened for complications, nor had antifungal treatment. The study highlighted the role of Infectious Diseases consultation for candidaemia.