1887

Abstract

This study reports for the first time, to our knowledge, descriptive epidemiological data for 188 invasive isolates from Pakistan, including species identification and antifungal susceptibility against fluconazole, itraconazole, voriconazole, caspofungin, micafungin, anidulafungin and amphotericin. Risk factors for invasive candidiasis (IC) were determined for 96 patients from Karachi, Pakistan. In adults and neonates, (38 and 36 %, respectively) was the most common species, followed in adults by (17.8 %), (15.9 %) and (12.3 %). (21 %) was the second most common in neonates. In children, (31.9 %), (26.4 %) and (19.4 %) were the most common. IC was significantly associated with paediatric age [crude odds ratio (COR) 3.46, 95 % confidence interval (CI) 1.63–7.32]. Rare species made up 17.5 % of the total isolates studied. Resistance to fluconazole was seen in (15 .0%) and (100 .0%). Only one isolate () was resistant to all three echinocandins. Low MICs of fluconazole for 98 % (184/188) of isolates tested support its continued use as an empiric therapy for IC. Non- IC was associated with the use of β-lactam inhibitor combinations (COR 3.16, 95 % CI 1.05–9.57). Use of healthcare devices was documented in 85.4 % of IC patients, whilst 75 .0% had been admitted to special care units. Surprisingly, 66.7 % of patients with IC were not obviously immunosuppressed. The high frequency of modifiable risk factors in this population indicates that candidaemia can be reduced with stringent antibiotic and infection control measures. These data will be useful for empiric selection of antifungals in Karachi, and contribute to global assessments of antifungal resistance.

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2013-02-01
2024-03-29
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