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Int J Infect Dis. 2013 Aug;17(8):e621-3. doi: 10.1016/j.ijid.2013.02.010. Epub 2013 Mar 25.

Candidemia among adults in Soweto, South Africa, 1990-2007.

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  • 1Division of Infectious Diseases, Department of Medicine, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Bertsham, Johannesburg, South Africa.



Studies on candidemia occurring among adults in Southern African are limited. We aimed to document the epidemiology of candidemia among adults in Soweto.


This was a retrospective hospital-based study in three discrete periods, involving 9 years, from 1990 to 2007.


Two hundred and sixty-six patients were identified. Case rates were 2.8 cases/10 000 admissions in 1998-2002 and 3.6 episodes/10 000 hospitalizations in 2005-2007. In 1990, Candida albicans caused 62% and Candida tropicalis caused 23% of episodes. In 2005-2007, major species were C. albicans (46%), Candida parapsilosis (25%), and Candida glabrata (23%), with little change compared to 1998-2002. Major predisposing conditions were abdominal surgery (43%), HIV infection (19% in 2005-2007), trauma (16%), diabetes mellitus (12%), and cancer (8%). General wards superseded intensive care as the major diagnostic setting in 2005-2007. The crude mortality was 60%. Among 22 HIV-infected patients with a median CD4 cell count of 68/μl, three were of community-onset. C. albicans caused 73% of cases. Five patients had another predisposing condition and five had central venous catheters. The mortality was 73%.


Soweto has a pattern of Candida species different from other continents. HIV infection and trauma were important predisposing conditions.

Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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