Epidemiological and Mycological Characteristics of Candidemia in Iran: A Systematic Review and Meta-Analysis; [Caracteristiques Epidemiologiques Et Mycologiques De La Candidemie En Iran : Revue Systematique Et Meta-Analyse] Publisher Pubmed



Vaezi A^{1, 2} ; Fakhim H² ; Khodavaisy S³ ; Alizadeh A⁴ ; Nazeri M⁵ ; Soleimani A⁶ ; Boekhout T^{7, 8} ; Badali H^{2, 9} Show Affiliations
Source: Journal de Mycologie Medicale Published:2017

Abstract

To date, there has been no comprehensive review of the epidemiology, risk factors, species distribution, and outcomes of candidemia in Iran. This study aimed to perform a systematic review and meta-analysis of all reported candidemia cases in Iran until December 2015. The review process occurred in three steps, namely a literature search, data extraction and statistical analyses. After a comprehensive literature search, we identified 55 cases. The mean age of patients was 46.80 ± 24.30 years (range 1–81 years). The main risk factors for candidemia were surgery and burns (23.6%), followed by malignancies (20%), use of broad-spectrum antibiotics (18.2%), and diabetes (7.3%). Candida parapsilosis (n = 17, 30.8%) was the leading agent, followed by Candida albicans (n = 15, 27.3%), Candida glabrata (n = 10, 18.2%), and Candida tropicalis (n = 8, 14.5%). The frequencies of candidemia cases due to C. glabrata, C. parapsilosis, and C. albicans were significantly higher among patients aged > 60, 21–40, and 41–60 years, respectively. Comparison of risk factors for candidemia by multiple logistic regression showed that one of the most important risk factors was surgery (OR: 4.245; 95% CI: 1.141–15.789; P = 0.031). The outcome was recorded in only 19 cases and 13 of those patients (68.4%) expired. This study confirms that knowledge of the local epidemiology is important when conducting surveillance studies to prevent and control candidemia and will be of interest for antifungal stewardship. © 2017 Elsevier Masson SAS