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Candidemia in Febrile Neutropenic Patients; a Brief Report

Maysam Yousefi, Davood Yadegarynia, Ensieh Lotfali, Zahra Arab-Mazar, Ali Ghajari, Alireza Fatemi




Introduction: Febrile neutropenic patients are at risk of serious infections. The aim of the present study is to identify the frequency, species, and susceptibility patterns of candidemia in febrile neutropenic patients. Methods: This cross-sectional study was conducted on febrile neutropenic patients suspected with candidemia who had been referred to 3 educational hospitals during 9 months. Results: The blood samples of 80 febrile neutropenic patients with the mean age of 48§16.6 years were studied (60% female). Five (6.25%) episodes of candidemia were identified. The underlying disease was acute myeloid leukemia in 4 (80%) cases and all 5(100%) cases had central venous catheter and were receiving prophylactic ciprofloxacin and acyclovir. 100% of isolates were found to be susceptible to Voriconazole, 80% to Caspofungin, 60% to Amphotericin B, and 40% to Fluconazole. Conclusion: The frequency of candidemia among the studied febrile neutropenia patients was 6.25%, with 80% mortality rate, and themost frequently identified yeastwas Candida albicans (100% susceptible to Voriconazole).


Candidemia; febrile neutropenia; antifungal agents; drug resistance,multiple, fungal


Talcott JA, Siegel R, Finberg R, Goldman L. Risk assessment in cancer patients with fever and neutropenia: a prospective, two-center validation of a prediction rule. Journal of Clinical Oncology. 1992;10(2):316-22.

Santucci S, Gobara S, Santos C, Fontana C, Levin A. Infections in a burn intensive care unit: experience of seven years. Journal of Hospital Infection. 2003;53(1):6-13.

Lotfi N, Shokohi T, Nouranibaladezaei SZ, Omran AN, Kondori N. High recovery rate of non-albicans Candida

species isolated from burn patients with candidemia in Iran. Jundishapur journal of microbiology. 2015;8(10).

Pfaller M, Diekema D, Jones R, Sader HS, Fluit A, Hollis R, et al. International Surveillance of Bloodstream Infections Due to Candida Species: Frequency of Occurrence and In Vitro Susceptibilities to Fluconazole, Ravuconazole, and Voriconazole of Isolates Collected from 1997 through 1999 in the SENTRY Antimicrobial Surveillance Program. Journal of Clinical Microbiology. 2001;39(9):3254-9.

Yapar N. Epidemiology and risk factors for invasive candidiasis. Therapeutics and clinical risk management. 2014;10:95.

Zirkel J, Klinker H, Kuhn A, Abele-Horn M, TappeD, Turnwald D, et al. Epidemiology of Candida blood stream infections in patients with hematological malignancies or solid tumors.Medical mycology. 2012;50(1):50-5.

Das I,Nightingale P, Patel M, Jumaa P. Epidemiology, clinical characteristics, and outcome of candidemia: experience

in a tertiary referral center in the UK. International Journal of Infectious Diseases. 2011;15(11):e759-e63.

Edmond MB, Wallace SE, McClish DK, Pfaller MA, Jones RN, Wenzel RP. Nosocomial bloodstream infections in

United States hospitals: a three-year analysis. Clinical infectious diseases. 1999;29(2):239-44.

VoiculescuM, Iliescu L, Ionescu C,Micu L, Ismail G, Zilisteanu D, et al. A cross-sectional epidemiological study of HBV, HCV, HDV and HEV prevalence in the Sub-Carpathian and South-Eastern regions of Romania. J Gastrointestin Liver Dis. 2010;19(1):43-8.

Yadegarynia D, Fatemi A, Mahdizadeh M, Movahhed RK, Alizadeh MA. Current spectrum of bacterial infections in patients with nosocomial fever and neutropenia. Caspian journal of internalmedicine. 2013;4(3):698.

Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clinical infectious diseases. 2004;39(3):309-17.

Zorgani A, Franka R, Zaidi M, Alshweref U, Elgmati M. Trends in nosocomial bloodstream infections in a burn intensive care unit: an eight-year survey. Annals of burns and fire disasters. 2010;23(2):88.

Zaoutis T. Candidemia in children. Current medical research and opinion. 2010;26(7):1761-8.

Ghahri M,Mirhendi H, Zomorodian K, Kondori N. Identification and antifungal susceptibility patterns of Candida strains isolated fromblood specimens in Iran. Archives of Clinical Infectious Diseases. 2013;8(3).

Krcmery V, Barnes A. Non-albicans Candida spp. causing fungaemia: pathogenicity and antifungal resistance. Journal of Hospital Infection. 2002;50(4):243-60.

Nicholson A, Rainford L. The epidemiology of fungaemia at the University Hospital of the West Indies, Kingston, Jamaica.West IndianMedical Journal. 2009;58(6):580-4.

Tortorano A, Caspani L, Rigoni A, Biraghi E, Sicignano A, Viviani M. Candidosis in the intensive care unit: a 20-year survey. Journal of Hospital Infection. 2004;57(1):8-13.

Kett DH, Azoulay E, Echeverria PM, Vincent J-L. Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study. Critical caremedicine. 2011;39(4):665-70.

Labbe A-C, Pepin J, Patino C, Castonguay S, Restieri C, Laverdiere M. A single-centre 10-year experience with Candida bloodstream infections. Canadian Journal of Infectious Diseases and Medical Microbiology. 2009;20(2):45-50.

Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE, et al. Clinical practice guidelines for the management candidiasis: 2009 update by the Infectious Diseases Society of America. Clinical infectious diseases. 2009;48(5):503-35.

Morrell M, Fraser VJ, Kollef MH. Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrobial agents and chemotherapy. 2005;49(9):3640-5.

DOI: https://doi.org/10.22037/emergency.v6i1.20237


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