Candidemia at a tertiary-care hospital: Epidemiology, treatment, clinical outcome and risk factors for death

The demographic, clinical and microbiological data of patients with candidemia at the "Hopital Universitario La Fe", a tertiary-care hospital in Valencia, Spain, from 1995 to 1997 was analyzed retrospectively. Candida spp. were isolated in blood cultures from 145 patients, 32% of whom were...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2002-11, Vol.21 (11), p.767-774
Main Authors: VIUDES, A, PEMAN, J, CANTON, E, UBEDA, P, LOPEZ-RIBOT, J. L, GOBERNADO, M
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Antibiotics
Antifungal Agents - therapeutic use
Biological and medical sciences
Candida - classification
Candida - isolation & purification
Candida albicans
Candida krusei
Candida parapsilosis
Candida tropicalis
Candidiasis - diagnosis
Candidiasis - drug therapy
Candidiasis - epidemiology
Child
Child, Preschool
Clinical outcomes
Epidemiology
Female
Fungemia - diagnosis
Fungemia - drug therapy
Fungemia - epidemiology
Hospital Mortality - trends
Human mycoses
Humans
Incidence
Infant
Infant, Newborn
Infectious diseases
Male
Medical instruments
Medical sciences
Middle Aged
Mortality
Multivariate analysis
Mycoses
Mycotic sepsis
Neonates
Retrospective Studies
Risk Factors
Severity of Illness Index
Sex Distribution
Spain - epidemiology
Survival Analysis
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Summary:The demographic, clinical and microbiological data of patients with candidemia at the "Hopital Universitario La Fe", a tertiary-care hospital in Valencia, Spain, from 1995 to 1997 was analyzed retrospectively. Candida spp. were isolated in blood cultures from 145 patients, 32% of whom were children (25% of these were neonates). The most common species isolated was Candida albicans, followed by Candida parapsilosis, Candida krusei and Candida tropicalis. Risk factors for candidemia included underlying disease, therapy with broad-spectrum antibiotics and the presence of a central venous catheter. The majority of children were treated with amphotericin B, whereas 52% of adults received fluconazole. Overall mortality was 44% (30% in children and 50% in adults), and attributable mortality was 30% (24% in children and 33% in adults). Multivariate analysis indicated that neutropenia, corticosteroid therapy, lack of antifungal treatment, and failure to replace the central venous catheter were factors associated with candidemia-related death. Among the adult population, an APACHE II score greater than 15 predicted candidemia-related death.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-002-0822-1