High recovery rate of non-albicans Candida Species in blood from burn patients with candidemia in Iran

Background: Blood stream infections (BSI) are major causes of morbidity and mortality in burn patients. Microorganisms responsible for BSI are generally bacteria, however Candida spp. are the infection agents in as many as 8% of all cases. Burn wound colonization and infections are generally the first steps to systemic infection. Candidemia in burn patients has been associated with high mortality and a prolonged hospital stay. Candidemia in burn patients has been defined as a pre-terminal event, leading to high morbidity and mortality rates among these patients. The aim of the study was to establish the incidence of candidemia in burn patients in Iran.Methods: We consecutively collected 405 blood samples from 113 burn patients. The yeasts isolates were identified to the species level using conventional procedures. In vitro antifungal susceptibility of the Candida isolates to amphotericin B, fluconazole, voriconazole and caspofungin was performed using Etest.Results: Twenty-seven (6.7%) of the blood cultures from 13 (12%) of the patients were positive for Candida species. C. parapsilosis (38%) and C. tropicalis (38%) were the most commonly found Candida species, followed by C. albicans (15%) and C. guilliermondii (15%) in those patients. The incidence of candidemia was significantly correlated with increased duration of hospitalization, increased time of stay in the intensive care unit, and higher mortality. The antifungal susceptibility tests demonstrated that amphotericin B and voriconazole had the lowest MICs against Candida spp.Conclusion: Non-albicans Candida should be a considered as significant pathogens in burned patients with candidemia.