Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital

Introduction: Recently there has been a significant increase in the incidence of fungal infections attributed to Candida species worldwide, with a major shift toward non-albicans Candida (NAC). Herein, we described the distribution of Candida species among different departments in a Lebanese hospit...

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Main Authors: Lyn Awad, Hani Tamim, Ahmad Ibrahim, Dania Abdallah, Mohammad Salameh, Anas Mugharbil, Tamima Jisr, Nabila Droubi, Kamal Zahran, Rima Moghnieh
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2018-02-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/10105
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author Lyn Awad
Hani Tamim
Ahmad Ibrahim
Dania Abdallah
Mohammad Salameh
Anas Mugharbil
Tamima Jisr
Nabila Droubi
Kamal Zahran
Rima Moghnieh
author_facet Lyn Awad
Hani Tamim
Ahmad Ibrahim
Dania Abdallah
Mohammad Salameh
Anas Mugharbil
Tamima Jisr
Nabila Droubi
Kamal Zahran
Rima Moghnieh
author_sort Lyn Awad
collection DOAJ
description Introduction: Recently there has been a significant increase in the incidence of fungal infections attributed to Candida species worldwide, with a major shift toward non-albicans Candida (NAC). Herein, we described the distribution of Candida species among different departments in a Lebanese hospital and calculated the antifungal consumption in this facility. We, then, correlated the consumption of antifungals and the prevalence of Candida species. Methodology: This was a retrospective study of Candida isolates recovered from the hospital microbiology laboratory database between 2010 and 2015. Data on antifungal consumption between 2008 and 2015 were extracted from the hospital pharmacy database. Spearman's coefficient was employed to find a correlation between Candida species distribution and antifungal consumption. Results: The highest antifungal consumption was seen in the haematology/oncology department (days of therapy/1000 patient days = 348.12 ± 85.41), and the lowest in the obstetrics department (1.36 ± 0.47). The difference in antifungal consumption among various departments was statistically significant (p < 0.0001). Azoles were the most common first-line antifungals. A non-homologous distribution of albicans vs. non-albicans was noted among different departments (p = 0.02). The most commonly isolated NAC was Candida glabrata, representing 14% of total isolates and 59% of NAC. The total antifungal consumption correlated positively with the emergence of NAC. The use of azoles correlated positively with Candida glabrata, while amphotericin B formulations correlated negatively with it. None of these correlations reached statistical significance. Conclusion: Different Candida species were unequally distributed among different hospital departments, and this correlated with consumption of antifungals in respective departments, highlighting the need for antifungal stewardship.
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institution Kabale University
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spelling doaj-art-372a7aea5bd04ad2a0c9c04b2179e5f62025-08-20T03:52:42ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802018-02-011202.110.3855/jidc.10105Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospitalLyn Awad0Hani Tamim1Ahmad Ibrahim2Dania Abdallah3Mohammad Salameh4Anas Mugharbil5Tamima Jisr6Nabila Droubi7Kamal Zahran8Rima Moghnieh9Pharmacy Department, Makassed General Hospital, Beirut, LebanonDepartment of Internal Medicine, American University of Beirut, Beirut, LebanonDivision of Hematology/Oncology, Department of Internal Medicine, Makassed General Hospital, Beirut, LebanonPharmacy Department, Makassed General Hospital, Beirut, LebanonDepartment of Internal Medicine, Makassed General Hospital, Beirut, LebanonDivision of Hematology/Oncology, Department of Internal Medicine, Makassed General Hospital, Beirut, LebanonDepartment of Laboratory Medicine, Makassed General Hospital, Beirut, LebanonPharmacy Department, Makassed General Hospital, Beirut, LebanonMiddle East Institute of Health, Bsalim, LebanonMakassed General Hospital, Beirut, Lebanon Introduction: Recently there has been a significant increase in the incidence of fungal infections attributed to Candida species worldwide, with a major shift toward non-albicans Candida (NAC). Herein, we described the distribution of Candida species among different departments in a Lebanese hospital and calculated the antifungal consumption in this facility. We, then, correlated the consumption of antifungals and the prevalence of Candida species. Methodology: This was a retrospective study of Candida isolates recovered from the hospital microbiology laboratory database between 2010 and 2015. Data on antifungal consumption between 2008 and 2015 were extracted from the hospital pharmacy database. Spearman's coefficient was employed to find a correlation between Candida species distribution and antifungal consumption. Results: The highest antifungal consumption was seen in the haematology/oncology department (days of therapy/1000 patient days = 348.12 ± 85.41), and the lowest in the obstetrics department (1.36 ± 0.47). The difference in antifungal consumption among various departments was statistically significant (p < 0.0001). Azoles were the most common first-line antifungals. A non-homologous distribution of albicans vs. non-albicans was noted among different departments (p = 0.02). The most commonly isolated NAC was Candida glabrata, representing 14% of total isolates and 59% of NAC. The total antifungal consumption correlated positively with the emergence of NAC. The use of azoles correlated positively with Candida glabrata, while amphotericin B formulations correlated negatively with it. None of these correlations reached statistical significance. Conclusion: Different Candida species were unequally distributed among different hospital departments, and this correlated with consumption of antifungals in respective departments, highlighting the need for antifungal stewardship. https://jidc.org/index.php/journal/article/view/10105antifungalCandida speciesconsumptioncritical careobstetricsoncology
spellingShingle Lyn Awad
Hani Tamim
Ahmad Ibrahim
Dania Abdallah
Mohammad Salameh
Anas Mugharbil
Tamima Jisr
Nabila Droubi
Kamal Zahran
Rima Moghnieh
Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital
Journal of Infection in Developing Countries
antifungal
Candida species
consumption
critical care
obstetrics
oncology
title Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital
title_full Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital
title_fullStr Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital
title_full_unstemmed Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital
title_short Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital
title_sort correlation between antifungal consumption and distribution of candida spp in different departments of a lebanese hospital
topic antifungal
Candida species
consumption
critical care
obstetrics
oncology
url https://jidc.org/index.php/journal/article/view/10105
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