Epidemiology, species distribution, antifungal susceptibility and outcome of candidemia among Internal Medicine Wards of community hospitals of Udine province, Italy

Candidemia is an emerging problem among patients hospitalized in Internal Medicine Wards (IMW). We performed a retrospective study to assess the epidemiology, species distribution, antifungal susceptibility and outcome of candidaemia recorded over a 3-year period (2010-2012) among IMW of community hospitals of Udine province in Italy: forty-eight patients were identified, with an overall incidence of 1.44 cases/1000 hospital admissions/year. Candida albicans was the most frequent species, followed by Candida parapsilosis that accounted for 42.9% of Tolmezzo cases. All isolates were susceptible to amphotericin and caspofungin, while 11.4% of strains were not-susceptible to voriconazole and 14.3% to fluconazole. Crude mortality was 41.7%. In conclusion, in community hospitals overall incidence of candidemia is similar to tertiary care hospitals, but 80% of cases are detected in IMW. Candida species distribution is overlapping, but differences in local epidemiology were found and should be taken into consideration. No resistance to amphotericin and caspofungin was found while resistance to azoles was observed. Knowledge of this data might be useful when planning the best therapeutic strategy.