Seven-year trend analysis of nosocomial candidemia and antifungal (fluconazole and caspofungin) use in Intensive Care Units at a Brazilian University Hospital

Candidemia is associated with high morbidity and mortality resulting in significant increases in the length of patients' hospitalization and in healthcare costs. Critically ill patients are at particular risk for candidemia because of their debilitated condition and frequent need for invasive p...

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Published in:Medical mycology (Oxford) 2008-01, Vol.46 (6), p.581-588
Main Authors: Girão, E., Levin, A.S., Basso, M., Gobara, S., Gomes, L.B., Medeiros, E. A. S., Costa, S. F.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antifungal Agents - therapeutic use
Brazil - epidemiology
Candida
Candidiasis - drug therapy
Candidiasis - epidemiology
Candidiasis - microbiology
Child
Cross Infection - drug therapy
Cross Infection - epidemiology
Cross Infection - microbiology
Echinocandins - therapeutic use
Female
Fluconazole - therapeutic use
Hospitals, University
Humans
Incidence
Intensive Care Units
Lipopeptides
Male
Middle Aged
Young Adult
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Summary:Candidemia is associated with high morbidity and mortality resulting in significant increases in the length of patients' hospitalization and in healthcare costs. Critically ill patients are at particular risk for candidemia because of their debilitated condition and frequent need for invasive procedures. The aim of this study was to characterize the incidence and epidemiology of candidemia over a seven-year period in intensive care units (ICUs) and the use of fluconazole and caspofungin in a large university-affiliated hospital. All cases of candidemia were identified by surveillance, using the Centers for Diseases Control and Prevention criteria. Demographic variables, use of antifungal (fluconazole and caspofungin) and patient outcomes were evaluated. The 2 test for linear trend was employed to evaluate the distribution of Candida spp. and the use of fluconazole and caspofungin by defined daily dose (DDD) per 1,000 patients-days during the study period. One hundred and eight episodes of candidemia were identified. The overall incidence of candidemia (P=0.20) and incidence of non-Candida albicans Candida infections (P=0.32) remained stable over the study period and ranged from 0.3-0.9 episodes per 1,000 catheter-days and 0.39-0.83 episodes per 1,000 patients-days. However, the use of fluconazole and caspofungin increased significantly (P
ISSN:1369-3786
1460-2709
DOI:10.1080/13693780802004996