Epidemiological trends in nosocomial candidemia in intensive care

Infection represents a frequent complication among patients in Intensive Care Units (ICUs) and mortality is high. In particular, the incidence of fungal infections, especially due to Candida spp., has been increasing during the last years. In a retrospective study we studied the etiology of candidem...

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Bibliographic Details
Published in:BMC infectious diseases 2006-02, Vol.6 (1), p.21-21, Article 21
Main Authors: Bassetti, Matteo, Righi, Elda, Costa, Alessandro, Fasce, Roberta, Molinari, Maria Pia, Rosso, Raffaella, Pallavicini, Franco Bobbio, Viscoli, Claudio
Format: Article
Language:English
Subjects:
Adult
Aged
Antifungal Agents - therapeutic use
Candida
Candida - classification
Candidiasis - drug therapy
Candidiasis - epidemiology
Candidiasis - microbiology
Cross Infection - drug therapy
Cross Infection - epidemiology
Cross Infection - microbiology
Drug Utilization
Female
Fluconazole - therapeutic use
Fungemia - drug therapy
Fungemia - epidemiology
Fungemia - microbiology
Humans
Logistic Models
Male
Middle Aged
Retrospective Studies
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Summary:Infection represents a frequent complication among patients in Intensive Care Units (ICUs) and mortality is high. In particular, the incidence of fungal infections, especially due to Candida spp., has been increasing during the last years. In a retrospective study we studied the etiology of candidemia in critically ill patients over a five-year period (1999-2003) in the ICU of the San Martino University Hospital in Genoa, Italy. In total, 182 episodes of candidaemia were identified, with an average incidence of 2.22 episodes/10,000 patient-days/year (range 1.25-3.06 episodes). Incidence of candidemia increased during the study period from 1.25 in 1999 to 3.06/10,000 patient-days/year in 2003. Overall, 40% of the fungemia episodes (74/182) were due to C.albicans, followed by C. parapsilosis (23%), C.glabrata (15%), C.tropicalis (9%) and other species (13%). Candidemia due to non-albicans species increased and this was apparently correlated with an increasing use of azoles for prophylaxis or empirical treatment. The study demonstrates a shift in the species of Candida causing fungemia in a medical and surgical ICU population during a 5 year period. The knowledge of the local epidemiological trends in Candida species isolated in blood cultures is important to guide therapeutic choices.
ISSN:1471-2334
1471-2334
DOI:10.1186/1471-2334-6-21