Antibiotic exposure as a risk factor for secondary Candida infections in a private hospital intensive care unit

Abstract

Candida is the most common fungal pathogen and the leading cause of invasive candidiasis in humans. The range of infections caused by Candida is vast, and the increased use of potent broad-spectrum antimicrobial agents contributes to the prevalence of worldwide fungal infections. Antibiotic administration and surgical intervention in patients often result in a profound alteration of protective endogenous flora, promoting overgrowth and translocation of fungi causing secondary invasive infections. Such infections result in a consequent rise in negative patient outcomes and are often associated with high incidences of morbidity, mortality and an overall increase in cost. This quantitative, cross-sectional cohort study assessed antibiotic exposure as a direct risk for the occurrence of secondary Candida infections in intensive care unit (ICU) patients. The study assessed whether the use of, and prolonged exposure to, broad spectrum antibiotics increased the prevalence of secondary Candida infections in the ICU of a private hospital located in Klerksdorp, North West Province in South Africa. The study included a total of 220 patients. Results revealed that 81 patients (85.0%) within the cases group were exposed to multiple antibiotics for a length of stay (LOS) ≥ 7 days. In a stark contrast, the control group displayed a mere 16 patients (15%) with a LOS ≥ 7 days. Prevalence of Candida infection was significantly higher in patients exposed to antibiotic treatment for an extended duration (p < 0.001). Antibiotic exposure was identified and evaluated as a direct risk for the occurrence of secondary Candida infections in ICU patients.