Find in Library

The <i>Candida</i> species cause a majority of invasive fungal infections. In this article, we describe the nationwide epidemiology of candidemia in Kuwait in 2018. Yeast bloodstream isolates submitted from all major hospitals and identified by phenotypic MALDI-TOF MS and/or by molecular methods were studied. Susceptibility testing was performed by Etest. Out of 313 bloodstream yeasts, 239 <i>Candida</i> spp. isolates (excluding duplicate isolates) were obtained during 234 candidemic episodes among 223 patients. Mixed-species candidemia and re-infection occurred in 5 and 11 patients, respectively. <i>C. albicans</i> (<i>n</i> = 74), <i>C. parapsilosis</i> (<i>n</i> = 54), <i>C. tropicalis</i> (<i>n</i> = 35), <i>C. auris</i> (<i>n</i> = 33), <i>C. glabrata</i> (<i>n</i> = 32), other <i>Candida</i> spp. (<i>n</i> = 11), and other yeasts (<i>n</i> = 9) caused fungemia. Nearly 50% of patients were in intensive care units. <i>Candida</i> spp. isolates (except <i>C. glabrata</i>) were susceptible to caspofungin and 27% of <i>C. auris</i> were amphotericin B-resistant. Resistance to fluconazole was 100% in <i>C. auris</i>, 17% in <i>C. parapsilosis,</i> 12% in <i>C. glabrata,</i> and 1% in <i>C. albicans</i>. Mortality was 47% for other <i>Candida</i>/yeast infections. Nationwide candidemia incidence in 2018 was 5.29 cases/100,000 inhabitants. Changes in species spectrum, increasing fluconazole resistance in <i>C. parapsilosis,</i> and the emergence of <i>C. auris</i> as a major pathogen in Kuwait are noteworthy findings. The data could be of help in informing decisions regarding planning, in the allocation of resources, and in antimicrobial stewardship.