European Confederation of Medical Mycology (ECMM) prospective survey of candidaemia: report from one Italian region

An ECMM epidemiological prospective survey of candidaemia was performed in one Italian region (Lombardy; population: 8 924 870) by the National Society of Medical Mycology (FIMUA) from September 1997 to December 1999. In total, 569 episodes were reported with an overall rate of 0.38/1000 admissions,...

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Bibliographic Details
Published in:The Journal of hospital infection 2002-08, Vol.51 (4), p.297-304
Main Authors: Tortorano, A.M., Biraghi, E., Astolfi, A., Ossi, C., Tejada, M., Farina, C., Perin, S., Bonaccorso, C., Cavanna, C., Raballo, A., Grossi, A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Biological and medical sciences
Candidiasis - epidemiology
Candidiasis - microbiology
Candidiasis - mortality
Causality
Child
Child, Preschool
Cross Infection - epidemiology
Cross Infection - microbiology
Cross Infection - mortality
Fungemia - epidemiology
Fungemia - microbiology
Fungemia - mortality
Health Facility Size
Human mycoses
Humans
Incidence
Infant
Infant, Newborn
Infectious diseases
Italy - epidemiology
Medical sciences
Middle Aged
Mycoses
Mycotic sepsis
Nosocomial infection, epidemiology, Candida spp., Italy
Prospective Studies
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Summary:An ECMM epidemiological prospective survey of candidaemia was performed in one Italian region (Lombardy; population: 8 924 870) by the National Society of Medical Mycology (FIMUA) from September 1997 to December 1999. In total, 569 episodes were reported with an overall rate of 0.38/1000 admissions, 4.4/100000 patient days. Predisposing factors included presence of an intravascular catheter (89%), antibiotic treatment (88%), surgery (56%), intensive care (45%), solid tumour (28%), steroid treatment (15%), haematological malignancy (7%), HIV infection (6%), fetal immaturity (4%). Mucous membrane colonization preceded candidaemia in 83% of patients. Candida albicans was identified in 58% of cases, followed by Candida parapsilosis (15%), Candida glabrata (13%), Candida tropicalis (6%). Septic shock occurred in 95 patients. Crude mortality was 35%, the highest in C. tropicalis fungaemia (44%), the elderly (64%) and solid tumour cancer patients (43%). Intravascular catheter removal was associated with higher survival rate (71 vs. 47%). This survey underscores the importance of candidaemia in hospital settings.
ISSN:0195-6701
1532-2939
DOI:10.1053/jhin.2002.1261